title: Prevalence and repair of inguinal hernias in children with bladder exstrophy.
abstract: OBJECTIVE
  We delineated the prevalence, recurrence rates and optimal treatment of inguinal hernia in the exstrophy population.
  
  
  METHODS
  Of 181 children with exstrophy followed at our hospital inguinal hernias developed in 121 (66.8%).
  
  
  RESULTS
  In a 12-year period inguinal hernias developed in 81.8% of the boys and 10.5% of the girls. In 18.2% of the cases the hernia was repaired via a preperitoneal approach at the same time as exstrophy closure. The remaining patients underwent an inguinal operation. Most patients had a wide defect at the internal ring in addition to a patent processus vaginalis. The overall recurrence rate was 8.3%. The incidence of synchronous or asynchronous bilaterality was 81.8%.
  
  
  CONCLUSIONS
  Children with bladder exstrophy should be carefully examined for inguinal hernias before bladder closure. If a unilateral hernia is present, the contralateral side should be explored. Careful preperitoneal repair should emphasize repair of the internal ring.
authors.affiliation: Division of Pediatric Urology, James Buchanan Brady Urological Institute, Johns Hopkins Hospital, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287-2101, USA.
authors.forename: J A
authors.initials: JA
authors.lastname: Connolly
authors.forename: D S
authors.initials: DS
authors.lastname: Peppas
authors.forename: R D
authors.initials: RD
authors.lastname: Jeffs
authors.forename: J P
authors.initials: JP
authors.lastname: Gearhart
mesh_terms: D000293:Adolescent; D000328:Adult; D001746:Bladder Exstrophy / Q000150:complications / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006552:Hernia, Inguinal / Q000453:epidemiology* / Q000209:etiology / Q000601:surgery*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D015995:Prevalence; D012008:Recurrence