Risk factors for inguinal hernia in adult male Nigerians: a case control study.
ABSTRACT We sought to evaluate selected risk factors for development of inguinal hernia in adult male Nigerians in a hospital based case control study. The aim was to identify the risks for this condition in our population. This may assist in instituting appropriate preventive measures towards early detection and treatment.
All male patients aged 18 years and above who presented with primary inguinal hernia at the General Surgical clinic of Ikorodu General Hospital between April 2009 and March 2011 were enrolled into the study as cases. Control subjects were selected randomly from the general out-patient clinic. Participants were interviewed during their first clinic attendance using a standardised questionnaire to record their bio-data and the presence or absence of the risk factors. All study cases had hernia repair and the type of hernia, whether indirect or direct was determined and documented. SPSS version 15.0 was used in the statistical analysis and the risk factors among the cases and controls were compared using univariate and multivariate logistic regression analysis.
A total number of 404 male patients were interviewed. Two hundred and two were the cases while the remaining 202 were the controls. Significant risk factors for inguinal hernia were positive family history of inguinal hernia (p < 0.001 and strenuous work activities (p < 0.001). Among the cases, 132 (65.3%) had indirect hernia while the remaining 70 (34.7%) had direct hernia. Positive family history (p = 0.011) and straining during urination or defecation (p = 0.047) were the factors significantly associated with the type of hernia.
Family history of inguinal hernia and strenuous work activity are the significant risk factors for this condition in our setting. Public health initiatives targeting those at higher risk of hernia development may help early detection and treatment; thereby reducing morbidity and mortality from this condition.
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ABSTRACT: The familial risk of abdominal wall hernia (AWH) is largely unknown. In addition, it is unknown whether inguinal hernia (IH), femoral hernia (FH), incisional hernia (INH), epigastric hernia (EH), and umbilical hernia (UH) share familial susceptibility. The aim of this nationwide study was to determine the familial risks of concordant AWH (same disease in proband and exposed relative) and discordant AWH (different disease in proband and exposed relative). Data from the Swedish Multigeneration Register on individuals aged 0 to 78 years were linked to the Swedish hospital discharge register and the Swedish outpatient register for the period from 1964 to 2010. Standardized incidence ratios (SIRs) and 95% CIs for surgically treated IH (n = 209,814 cases), FH (n = 4,576), INH (n = 19,494), EH (n = 8,257), and UH (n = 22,761) were calculated for siblings of individuals with hernia compared with the siblings of unaffected individuals. The procedure was repeated for spouses. All concordant and most discordant familial sibling risks were increased. Familial concordant SIRs for siblings were IH = 1.97 (95% CI, 1.94-1.99), FH = 3.40 (95% CI, 2.44-4.62), INH = 2.24 (95% CI, 2.04-2.46), EH = 5.57 (95% CI, 4.64-6.64), and UH = 3.61 (95% CI, 3.33-3.91). Concordant familial risks were higher than discordant risks. For example, when the proband sibling had IH, the discordant SIRs were FH = 1.74 (95% CI, 1.61-1.88), INH = 1.22 (95% CI, 1.16-1.28), EH = 1.30 (95% CI, 1.20-1.40), and UH = 1.35 (95% CI, 1.29-1.41). Concordant SIRs for spouses were lower: IH = 1.23 (95% CI, 1.20-1.26), FH = 0.97 (95% CI, 0.64-1.36), INH = 1.56 (95% CI, 1.41-1.71), EH = 1.70 (95% CI, 1.09-2.45), and UH = 1.31 (95% CI, 1.09-1.56). Family history of surgically treated AWH is an important risk factor for surgical treatment of AWH. The 5 forms of AWH studied share familial susceptibility, but site-specific familial factors might exist. Several spouse risks were increased, suggesting the possibility of a nongenetic contribution to familial risks.Journal of the American College of Surgeons 08/2013; 217(2):289-299.e1. · 4.45 Impact Factor