The risk of developing a symptomatic inguinal hernia in children with an asymptomatic patent processus vaginalis

Background: Children with a symptomatic indirect inguinal hernia have a patent processus vaginalis (PPV). However, the reverse is unknown, as the natural history of PPV is unclear. Currently, there are little data regarding the incidence and time frame for developing a symptomatic hernia with a known asymptomatic PPV. Methods: A retrospective chart review was conducted in children who were evaluated for a PPV during nonhernia laparoscopic surgery by a single pediatric surgeon (GWH) from 2000 to 2014. Those patients with intraoperative findings of PPV were followed up by chart review and phone inquiry. Results: 1548 children underwent a laparoscopic operation, with 308 having an asymptomatic PPV. Phone contact was successful in 125 (43%) of these patients at a median of 8.1 years (range 4.8-12.7) after the initial laparoscopic operation. Nineteen (13%) patients returnedwith a symptomatic hernia at amedian age of 17months (range: 5-74) and amedian presentation of 9months (range: 1-66) after the initial laparoscopy. Ten hernia repairswere unilateral and 9 bilateral. None of those who were contacted via phone inquiry reported hernia symptoms or hernia repair. Conclusions: These data suggest that the risk of developing a symptomatic hernia during childhood in the presence of a known PPV is relatively low. (C) 2017 Published by Elsevier Inc.