TRADITIONAL SCROTAL SUPPORT AFTER INGUINO SCROTAL HERNIA REPAIR- A HISTORICAL RITUAL OR A SCIENTIFIC MYTH ???

DR.S.TAMILSELVAN; DR.K.RAJACHIDAMBARAM; DR.S.K.MANOJ; Dr.Gowtham

Volume : VII, Issue : III, March - 2018

TRADITIONAL SCROTAL SUPPORT AFTER INGUINO SCROTAL HERNIA REPAIR- A HISTORICAL RITUAL OR A SCIENTIFIC MYTH ???

Dr. S. Tamilselvan, Dr. K. Rajachidambaram, Dr. S. K. Manoj, Dr. Gowtham

Abstract :

Scrotal hematoma and edema following an inguinoscrotal hernia surgery is believed to be a common scenario and hence the routine use of scrotal support to reduce the incidence of the hematoma has been a common surgical practice in India. The true incidences of the scrotal edema after these surgeries are not scientifically reported.

Aim of the study:

1) To evaluate the efficacy and clinical usage of scrotal support in patients undergoing elective inguinoscrotal surgery in our surgical unit.

2) To measure the true incidences of scrotal hematoma and edema in our surgical unit in a tertiary teaching referral centre.

Materials and Methods:

A prospective study was performed over a period of one year (March 2016 – March 2017). The study population were divided into two groups, Group-A with simple V shaped under garments and Group-B with conventional scrotal support (coconut bandage). All the surgeries were performed by two surgeons in one surgical unit. The study included all the inguinal hernias except bubonocele, paediatric hernias and recurrent hernias which were excluded from the study. The post operative findings were recorded individually by the surgeons and studied.

Results:

Total numbers of 156 inguinoscrotal hernia surgeries were performed. Of which, 126 were included in our prospective study. The rest of the cases were excluded based on the exclusion criteria. Of the 126 cases, 66 cases were in Group A and 60 cases were in Group B. All are male patients with the age ranges from 35 – 75 years (Average age 55). There were no significant co-morbidities. All the cases were funicular and complete indirect inguinal hernias. There were no femoral hernias. In Group A, 3 patients ( 3/66) i.e., 4.5% developed scrotal hematoma and edema and in Group B, 6 patients (6/60) i.e., 10% developed similar findings. None of the patients in Group A needed surgical intervention, whereas one patient (1/6) i.e., 1.5% needed surgical intervention. In group B patients, 10 patients (10/60) i.e., 16.6% developed penile edema and 30 patients (30/60) i.e., 50% complained of scrotal discomfort.

Conclusion:

Our study has shown that routine use of conventional scrotal support should be avoided as it has not reduced the incidences of scrotal hematoma and edema.