title: Laparoscopic diagnosis and repair of asymptomatic bilateral inguinal hernias.
abstract: BACKGROUND
  This study was designed to investigate age, sex, and side of hernia presentation at clinical examination as potential intrinsic risk factors for bilateral inguinal hernia (BIH), and to quantify the characteristics of clinical examination versus laparoscopy as a diagnostic tool for BIH.
  
  
  METHODS
  A cross-sectional study was utilized to analyze 99 consecutive patients undergoing laparoscopic inguinal hernia repair.
  
  
  RESULTS
  The incidence of BIH based on clinical examination alone was 49%, compared with 71% laparoscopically. Clinical examination of BIH resulted in 69% sensitivity, 100% specificity, 100% predictive value for bilateral diagnosis, and 57% predictive value for unilateral diagnosis. Left hernia presentation at clinical examination (prevalence rate ratio = 10.5, 95% confidence interval: 3.6 to 30.7) and male sex (prevalence rate ratio = 6.6, 95% confidence interval: 1.3 to 35.0) were found to be independent risk factors for BIH.
  
  
  CONCLUSIONS
  Laparoscopy yields detection of BIH that would be missed by clinical examination alone. Furthermore, left-sided hernia and male sex were associated with BIH.
authors.affiliation: Department of Surgery, College of Osteopathic Medicine, and Public Health Program, College of Allied Health, Nova Southeastern University, Ft. Lauderdale, FL, USA.
authors.forename: Aiden
authors.initials: A
authors.lastname: O'Rourke
authors.forename: Jason A
authors.initials: JA
authors.lastname: Zell
authors.forename: Tina T
authors.initials: TT
authors.lastname: Varkey-Zell
authors.forename: Julie L
authors.initials: JL
authors.lastname: Barone
authors.forename: Manuel
authors.initials: M
authors.lastname: Bayona
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D007839:Functional Laterality; D006552:Hernia, Inguinal / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D006801:Humans; D015994:Incidence; D010535:Laparoscopy / Q000379:methods* / Q000592:standards; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012737:Sex Factors