Groin hernias in patients 50 years of age and above pattern and outcome of management in 250 consecutive patients.

A prospective survey of 250 elderly patients was carried out over a period of 5 years (1992-1996) to determine the pattern, outcome and prognostic factors of inguinal hernia repair in this groups of patients. The result showed that the mean age to be 61.5 years with male patients of 90%. Hernia was commonest on the right side in 49.6%, and bilateral in 15.2%. They were inguinal hernia and inguinoscrotal hernia in 63.2% and 31.2% and 31.2% respectively and femoral hernia in 5.6%. In 51.2% of the patients there were associated diseases. In 24.8% lower obstructive uropathy was diagnosed, of 5.6% presented in acute urinary retention and 3 cases of carcinoma of the prostate. Cardiopulmonary diseases in 19.6%. The hernia was incarcerated in 22.4%. More than half (55%) were operated under local or regional anaesthesia. In 22.4%, additional operative procedures were carried out, of which 62.6% of such patients had prostatectomy. They mean hospital stay was 4 days, 60% were operated as day surgery. Postoperative complications of scrotal haematoma/oedema in 16.4%, wound infections of 14.4%, postoperative hernia recurrence of 2.8% and death occurred in 1.6% of the patients. The outcome were significantly affected by the age, associated diseases, hernia complications such as incarceration or strangulation and the need for additional surgical procedures.