unfavorable results in women

A vast North American study on more than 1. Therefore, 500 patients calls into question the universality of current recommendations on inguinal hernia cure operations, based mainly on male studies.

Retrospective series reported that women operated on for inguinal hernia was less good than men. Consequently, But they only represent about 10 % of inguinal hernia operated. Similarly, are often excluded from clinical studies, for fear of confounding factors. Nevertheless, Despite this, the recommendations vis-à-vis the treatment of inguinal hernias in women come from studies relating only to men! Therefore, To be clear. In addition, North American researchers carried out a study aimed at analyzing the differences in results between men and women who have been repaired by inguinal hernia, from a wide database (Abdominal Core Health Quality CollaborativeACHQC). Moreover,

A multicenter register and formalized prospective observations

ACHQC is a register held since 2013 by 446 surgeons in unfavorable results women 392 centers. Therefore, Observations are prospectively collected in a formalized way. In addition, At the time of publication, this register included 115,987 patients. To be eligible. the observations had to correspond to the treatment of a unilateral, elective inguinal hernia, with a plaque installation, include a 30-day follow-up as well as a quality of quality of life available both in pre-operative and 1 year (Eurahs). The technical modalities could be classic (open), laparoscopic or robotic. Additionally, The main evaluation criteria were the pain scores, functional discomfort as well as aesthetic satisfaction (EURAHS) at 1 year. The existence of a recurrence of the hernia at 1 year was also collected.

The data of 1,582 patients (1,448 men, 134 women), operated for an inguinal hernia cure between 2017 and 2022, with 1 year follow -up were retained. Furthermore, The results showed that women presented a median BMI lower than men (24 vs unfavorable results women 26, p <0.001). More women benefited from the Medicare program (p <0.002). There were more women than men with history of pelvic surgery (p <0.001) and BPCO (p = 0.016). Men were more often under anti-aggregates (p = 0.041). The technique chosen was mainly mini-invasive, more frequently in women. There were more femoral hernias (formerly crural) in women (7 % vs 0 %, p <0.001).

Open surgery would expose women to a higher risk of recurrence than mini-invasive surgery

At 1 year. women had overall and higher eurahs scores (p <0.01 and p <0.02 respectively) than men. In multivariate analysis, the female sex was associated with more pain (RRA 0.77; 95 %CI, 0.17-1.37, p <0.01) and less good results in terms of functional discomfort (RRA 1.66; 95 %CI, 0.76-2.56, p <0.01) and aesthetics (RRA 0.74; p <0.01) that men. The risk of recurrence was significantly higher in women (RRA 2.20; 95 %CI, unfavorable results women 1.10-4.41, p = 0.03).

Open surgery exposed women to a higher risk of recurrence than mini-invasive surgery. without a difference in risk of recurrence depending on the technique in men. All sexes combined. among the factors associated with a less good evolution, we noted the female sex, an initial eurahs high score (greater symptomatology), the existence of a recurrence of hernia as an operative indication, obesity (high BMI). On the other hand, advanced age seemed to be a protective factor.

The prognosis in terms of quality of life. recurrence is therefore less favorable for women operated with an inguinal hernia, even with mini-invasive techniques. These seem to decrease recurrence in women but do not abolish the differences in pain and embarrassment. There is a specific need for studies focused on female particularities to personalize management and reduce these inequalities.