Can volumetric measurement be used in the selection of treatment for inguinoscrotal hernias?

Özet

Objective: Inguinoscrotal hernias are often qualified subjectively as big, giant, scrotal, etc. In order to classify thistype of hernia, objective criteria are needed. For this purpose, we aimed to introduce a scrotal volume measurement-based classification system and propose a corresponding surgical plan (open or laparoscopic surgery, anterioror posterior repair) based on volumetric data.Material and Methods: Between October 2012 and October 2013, 30 consecutive male patients with a mean age of59.5 years (range: 36 to 82 years) presenting with unilateral ISH were included in this retrospective study. Physicalmeasurements in the upright position and computerized tomography measurements using the Valsalva maneuverwere obtained from all patients.Results: Of the 30 patients, 26 patients had scrotal volumes less than 1000 mL, two patients had SVs between 1001and 2000 mL, one patient had an SV between 2001 and 3000 mL, and one patient had an SV greater than 3000mL. Laparoscopic total extraperitoneal repair was performed in patients with scrotal volumes inferior to 1000 mL.In three patients with scrotal volumes between 1000 and 3000 mL, an open posterior approach was used. In onepatient with a scrotal volume superior to 3000 mL, no surgical intervention was performed due to the patient’scardiac comorbidity.Conclusion: By establishing a common language among surgeons, we believe that the volumetric measurementbasedscrotal hernia classification system proposed in this study will lead to further studies on the subject.