Sliding inguinal hernia is a risk factor for recurrence.

Objective: A sliding inguinal hernia is defined as a hernia where part of the hernial sac wall is formed by an organ, e.g., the colon or bladder. Thus, repair of a sliding inguinal hernia may have higher risk of complications and recurrence compared with non-sliding inguinal hernia. The aim of this study was to investigate the incidence and reoperation rates following sliding inguinal hernia repair.

Methods: This study was based on data from the Danish Hernia Database covering the period between January 1, 1998 and February 22, 2012. Data were collected prospectively and nationwide.

Results: In total, 70,091 primary hernia repairs were included for analysis. The occurrence of sliding inguinal hernias of the total group of included hernia repairs was 9.4 % among males and 2.9 % among females (p < 0.05). Among male patients, the sliding inguinal hernias had a higher cumulated reoperation rate compared with non-sliding inguinal hernias (6.0 versus 4.2 %, log-rank p = 0.001). A Cox regression model was fitted and showed that the type of repair affected the risk for reoperation for recurrence; hazard ratio (95 % confidence interval): open non-mesh: reference, Lichtenstein 0.43 (0.39-0.48), other open mesh 0.46 (0.39-0.54), laparoscopic 0.70 (0.60-0.84).

Conclusions: The incidence of sliding inguinal hernia is higher in males than in females, and sliding inguinal hernia is a risk factor for reoperation for recurrence. The Lichtenstein repair could be considered over the laparoscopic approach because of lower reoperation rates.