Laparoscopic diagnosis and repair of asymptomatic bilateral inguinal hernias

Background: This study was designed to investigate age, sex, and side of hernia presentation at clinical examination as potential intrinsic risk factors for bilateral inguinal hernia (BIH), and to quantify the characteristics of clinical examination versus laparoscopy as a diagnostic tool for BIH. Methods: A cross-sectional study was utilized to analyze 99 consecutive patients undergoing laparoscopic inguinal hernia repair. Results: The incidence of BIH based on clinical examination alone was 49%, compared with 71% laparoscopically. Clinical examination of BIH resulted in 69% sensitivity, 100% specificity, 100% predictive value for bilateral diagnosis, and 57% predictive value for unilateral diagnosis. Left hernia presentation at clinical examination (prevalence rate RATIO = 10.5, 95% confidence interval: 3.6 to 30.7) and male sex (prevalence rate RATIO = 6.6, 95% confidence interval: 1.3 to 35.0) were found to be independent risk factors for BIH. Conclusions: Laparoscopy yields detection of BIH that would be missed by clinical examination alone. Furthermore, left-sided hernia and male sex were associated with BIH.