Risk Factors associated with Inguinal Hernia in Adult Male: A Case-control Study

Abstract

Risk Factors associated with Inguinal Hernia in Adult Male: A Case-control Study

Anan Manomaipiboon MD, MSc (Clinical Epidemiology)*

Sawit Ampornareekul MD**

Vasin Chotivanich MD*

Nataphon Santrakul MD*

* Department of Surgery, BMA Medical College and Vajira Hospital

** Department of Surgery, Phrapinklao Hospital

Objective: To determine the association between heavy object lifting and occurrence of inguinal hernia in adult male and to identify the other risk factors of inguinal hernia in adult male

Study design: A case-control study.

Subjects: Two hundred and nineteen patients in two tertiary care hospitals - BMA Medical College and Vajira Hospital and Phrapinklao Hospital were enrolled in this study during June 2002 to March 2003, 73 patients as cases and 146 patients as controls. Cases were defined as newly diagnosed inguinal hernia in adult male with the duration of symptoms less than one year. The corrected diagnoses were confirmed from operative report. Previously surgical repairs of inguinal hernia were excluded. Controls were male in-patients during the same periods as cases. Controls were approximately age-matched within five years interval to cases. In-patients with urological, colo-rectal and cardio-thoracic diseases were not recruited as controls.

Methods: Both cases and controls were asked to answer the same questions on their demographic background, past history of heavy object lifting, smoking, urinary outflow tract obstruction, constipation, chronic cough. Their height and estimated body weights before occurrence of the diseases and previous appendectomy via right lower abdominal incision were recorded.

Results: In univariate and multivariate analysis, no association between all exposure variables and inguinal hernia were found. The adjusted odds ratio for inguinal hernia in relation to past history of heavy object lifting was 1.1 (95% CI, 0.6-2.2). The adjusted odds ratio in relation to smoking, increased intra-abdominal pressure, previous appendectomy and obesity were 1.0 (95% CI, 0.6-1.9), 1.1 (95% CI, 0.6-1.9), 1.3 (95% CI, 0.4-3.7) and 0.7 (95% CI, 0.3-1.3) respectivel

Conclusion: This study did not suggest an inverse effect between past history of heavy object lifting, smoking, urinary outflow tract obstruction, constipation, chronic cough, previous appendectomy and inguinal hernia.

Vajira Med J 2007 ; 51 : 179 - 187