Ovarian Incarceration and Torsion in Single-Ovary Versus Multiple-Reproductive Organ Prolapse in Female Inguinal Hernia: A Retrospective Study of 510 Infants Who Underwent Laparoscopic Hernia Repair.

ABSTRACT

Purpose: Although inguinal hernia repair is common in infants, few studies have focused on the condition in female infants. In female infantile inguinal hernia, there is a risk of oophorectomy when torsion and strangulation occur due to ovarian prolapse. We aimed to evaluate the risks of ovarian incarceration and torsion in single-ovary versus multiple-reproductive organ prolapse in female infantile inguinal hernia. Methods: Females ≤12 months old who underwent laparoscopic transabdominal inguinal hernia repair from September 2012 to December 2019 were retrospectively analyzed. If manual reduction failed at initial diagnosis, surgery was performed within 24 hours in all incarceration cases. The clinical characteristics and surgical outcomes were compared between those with single-organ versus multiple-organ prolapse. Results: Of 510 patients, 465 (91.2%) had single-organ prolapse, most commonly a single ovary (381/465), followed by intestine (84/465). Forty-five patients (8.8%) had multiple-organ prolapse, most commonly a single ovary plus intestine (27/45), followed by both ovaries plus the uterus (10/45). The manually irreducible incarceration rate was higher in patients with multiple-organ prolapse (57.8%) than single-organ prolapse (23.4%; P < .000). In patients with ovarian incarceration, the ovarian torsion rate was higher in the single-ovary group (38/109, 34.9%) than the multiple-organ group (1/26, 3.8%; P < .000). There was no significant difference between the two groups in recurrence or oophorectomy rate. Conclusion: Most female infantile inguinal hernias involve ovarian prolapse. There is a high risk of incarceration in multiple-organ prolapse and a high risk of ovarian torsion in single-ovary prolapse.