Inguinal Hernia Repairs in a Rural Setting in East Africa: A Clinical Approach| Chapter 01 | Issues and Developments in Medicine and Medical Research Vol. 3

 In the poor world, inguinal hernias are a leading source of morbidity and mortality. Due to the late presentation of inguinal hernias and the lack of availability and cost of mesh and laparoscopy in resource-constrained settings in rural Africa, clinical care of inguinal hernias may represent a therapeutic challenge to the surgeon. There is a scarcity of data and literature on the surgical treatment of inguinal hernias in our setting. Inguinal hernia affects 3% of women and 27% of men over their lifetime, with rates declining after 45 years of age. The goal of this study was to look at the clinical profile and results of inguinal hernia repair patients at our institution.

Methods: From April 1, 2008, to July 31, 2012, a descriptive retrospective study was conducted on all patients 15 years of age who had an inguinal hernia repair. The patients were evaluated on the surgical ward after surgery and again three months later at the surgical out-patient clinic. The following data were obtained using a pretested questionnaire: age, sex, recurrence of hernia, post-operative pain, and post-operative complications. Physical examination was performed to check for post-operative recurrence and evidence of haematomas, seromas, or acute wound sepsis that necessitated surgery.

The results of 158 patients who had an inguinal hernia repaired with the Modified Bassini method were studied. The average age was 44.84. The male to female ratio was 3.65:1, with males outnumbering females. 4 (2.53%) of patients had emergency inguinal hernia repairs, while the majority of patients, 154 (97.47%), had elective inguinal hernia repairs. 1(0.63 percent) seroma, 1(0.63 percent) haematoma, 1(0.63 percent) necrotizing fasciitis, and 1(0.63 percent) enterocutaneous fistula were among the morbidities. Overall, 3.16 percent of patients had complications.

Conclusions: Patients with inguinal hernias in rural Africa should be encouraged to present early with inguinal hernia signs and symptoms. Elective inguinal hernia surgery, regardless of the kind of repair, will reduce morbidity and death associated with this frequent condition in East Africa.

Author(S) Details

Richard Wismayer
Department of Surgery, St. Joseph’s Maracha Hospital, West Nile, Uganda and Department of Surgery, Habib Medical School, IUIU University, Kampala, Uganda.

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