Nationwide survey to evaluate medical utilization by patients with inguinal hernia and the risk of developing varicocele in Taiwan.
BACKGROUND
The purpose of this study was to analyze age, geographical and seasonal variations in medical service utilization by patients with inguinal hernia in Taiwan, and the influence of herniorrhaphy on development of ipsilateral varicocele in male patients.


METHODS
Between 2001 and 2008, comprehensive data on the characteristics of medical service utilization by patients with inguinal hernia was evaluated via a retrospective nationwide population-based study. Data were obtained from the National Health Insurance Research Database in Taiwan. Parameters for comparison included newly diagnosed inguinal hernia cases, number of herniorrhaphies, and incidence rates every year, number of outpatient visits for inguinal hernia, and herniorrhaphy by age, season, and area of Taiwan.


RESULTS
There was an average of 1,466 newly diagnosed inguinal hernia cases and 871.9 herniorrhaphies performed per year per million population during the study period. The male ratio for both newly diagnosed inguinal hernia cases and number of herniorrhaphies increased significantly by age. The number of newly diagnosed inguinal hernia cases and outpatient visits for inguinal hernia was highest during summer, followed by spring, autumn, and winter, and in the north of Taiwan, followed by the center, south, and east. Additionally, the incidence of developing ipsilateral varicocele after herniorrhaphy was low in male patients.


CONCLUSIONS
The number of newly diagnosed inguinal hernia cases and outpatient visits for inguinal hernia is highest during summer and lowest in eastern Taiwan. In addition, the incidence of developing ipsilateral varicocele after herniorrhaphy is higher in patients aged 10-19 years.
Taipei Databank for Public Health Analysis, Institute of Clinical Research and Teaching, Taipei City Hospital, Taipei, Taiwan.
Wen-Liang
WL
Liu
Institute of Preventive Medicine, National Taiwan University, Taipei, Taiwan.
Yu-An
YA
Chen
Division of Urology, Taipei City Hospital Renai Branch, Taipei, Taiwan ; Department of Urology, School of Medicine and Shu-Tien Urological Institute, National Yang-Ming University, Taipei, Taiwan.
Yu-Wei
YW
Lai
Division of Urology, Taipei City Hospital Renai Branch, Taipei, Taiwan ; Department of Urology, School of Medicine and Shu-Tien Urological Institute, National Yang-Ming University, Taipei, Taiwan.
Thomas Y
TY
Hsueh
Division of Urology, Taipei City Hospital Renai Branch, Taipei, Taiwan ; Department of Urology, School of Medicine and Shu-Tien Urological Institute, National Yang-Ming University, Taipei, Taiwan.
Shiou-Sheng
SS
Chen
Department of Urology, School of Medicine and Shu-Tien Urological Institute, National Yang-Ming University, Taipei, Taiwan.
Allen W
AW
Chiu
age; herniorrhaphy; inguinal hernia; season; varicocele