The missed diagnosis of femoral hernias in females undergoing inguinal hernia repair – A systematic review and proportional meta-analysis
- 01.12.2025
- Review
Erschienen in:
- Verfasst von
- Ana Caroline Dias Rasador
- Carlos André Balthazar da Silveira
- Gabriele Eckerdt Lech
- Bruno Veronez de Lima
- Diego Laurentino Lima
- Flavio Malcher
- Erschienen in
- Hernia | Ausgabe 1/2025
Abstract
Background
Given the 4-times higher prevalence of femoral hernias among females compared to males, this diagnosis may be missed during inguinal hernia repair (IHR), causing risk of reoperation for pseudo recurrence of femoral hernias (FH). Minimally invasive approaches are suggested as potential reducers of missed FH since they provide a posterior view of all defect areas, despite studies suggesting that women receive less MIS than men. We aim to assess the missed FH during IHR and after reoperation for recurrence following IHR in women.
Methods
PubMED, Cochrane, and EMBASE databases were searched for studies assessing patients undergoing recurrent IHR, analyzing the incidence of reoperation for FH and occult femoral hernias during IHR. Statistical analysis was performed using R software.
Results
From 6,226 records, 10 retrospective observational studies were included, totaling 15,863 patients (20% females). We found that 19.56 per 100 women (95% CI 8.34, 39.37) who are reoperated for an inguinal hernia are found as having a FH during the new repair. Compared to men, women were at a significantly higher risk to be reoperated for FH after IHR (RR 8.97; 95% CI 7.35, 10.93; P < 0.001). Our analysis also showed that 20.7% of females received MIS approaches for groin hernia repair, while 79.3% received open procedures. Furthermore, our study found a pooled incidence of occult FH during the initial IHR of 6.85 per 100 patients for both genders (95% CI 2.78, 15.90), which increased to 21.42 per 100 patients when assessing females only (95% CI 15.46, 28.89).
Conclusions
Females have a higher incidence of FH following reoperation for recurrence of inguinal hernia repair. Added to the high rate of occult FH encountered during inguinal procedures, this suggests a missed diagnosis of FH during IHR. The adoption of MIS IHR for women is fundamental to reduce the underdiagnosis of FH.
Anzeige
- Titel
- The missed diagnosis of femoral hernias in females undergoing inguinal hernia repair – A systematic review and proportional meta-analysis
- Verfasst von
-
Ana Caroline Dias Rasador
Carlos André Balthazar da Silveira
Gabriele Eckerdt Lech
Bruno Veronez de Lima
Diego Laurentino Lima
Flavio Malcher
- Publikationsdatum
- 01.12.2025
- Verlag
- Springer Paris
- Erschienen in
-
Hernia / Ausgabe 1/2025
Print ISSN: 1265-4906
Elektronische ISSN: 1248-9204 - DOI
- https://doi.org/10.1007/s10029-024-03196-5
Dieser Inhalt ist nur sichtbar, wenn du eingeloggt bist und die entsprechende Berechtigung hast.
