title: Are there any predictive factors of metachronous inguinal hernias in children with unilateral inguinal hernia?
abstract: OBJECTIVE
  This study was done to identify risk factors for metachronous manifestation of contralateral inguinal hernia in children with unilateral inguinal hernia.
  
  
  METHODS
  This is a retrospective study of 565 patients with inguinal hernia during a nine-year period at a single institution. Age, sex, and side of the hernia at presentation were recorded. The incidence of metachronous inguinal hernia and its risk factors were analyzed.
  
  
  RESULTS
  Of 565 children, 62 (11%) were presented with synchronous bilateral hernias. Of the remaining 503, a metachronous contralateral hernia developed in 22 (4.4%). The age at hernia repair of the patients with contralateral manifestation (18 ± 3.67 months; mean ± SD), was significantly younger than observed in the control patients (34 ± 1.34 months; p = 0.000). There was no significant difference between the groups in other factors such as the age at hernia presentation, the initial side of the hernia, birth weight. and the percentage of patients who had experienced incarceration.
  
  
  CONCLUSIONS
  We believe that the incidence is still too low to recommend routine contralateral exploration. Therefore, infants younger than 18 months appear to be a higher-risk subpopulation and should receive closer follow-up over this time period.
authors.affiliation: Department of Pediatric Surgery, Hedi Chaker Hospital, Sfax, Tunisia. mohamed.jallouli@rns.tn
authors.forename: M
authors.initials: M
authors.lastname: Jallouli
authors.forename: S
authors.initials: S
authors.lastname: Yaich
authors.forename: M B
authors.initials: MB
authors.lastname: Dhaou
authors.forename: H
authors.initials: H
authors.lastname: Yengui
authors.forename: D
authors.initials: D
authors.lastname: Trigui
authors.forename: J
authors.initials: J
authors.lastname: Damak
authors.forename: R
authors.initials: R
authors.lastname: Mhiri
mesh_terms: D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006552:Hernia, Inguinal / Q000453:epidemiology* / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D016016:Proportional Hazards Models; D012372:ROC Curve; D012189:Retrospective Studies; D012307:Risk Factors; D018709:Statistics, Nonparametric