Loading…
Risk factors for repeat hernia repair in women of childbearing age
Purpose Herniorrhaphy is a source of substantial cost and morbidity. Although women are a substantial proportion of patients seeking repair, gender-specific data, including the influence of childbirth on hernia recurrence, are lacking. Our objective was to estimate the rate and identify risk factors...
Saved in:
Published in: | Hernia : the journal of hernias and abdominal wall surgery 2020-06, Vol.24 (3), p.577-585 |
---|---|
Main Authors: | , , , |
Format: | Article |
Language: | English |
Subjects: | |
Citations: | Items that this one cites Items that cite this one |
Online Access: | Get full text |
Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
Summary: | Purpose
Herniorrhaphy is a source of substantial cost and morbidity. Although women are a substantial proportion of patients seeking repair, gender-specific data, including the influence of childbirth on hernia recurrence, are lacking. Our objective was to estimate the rate and identify risk factors for repeat herniorrhaphy in reproductive-aged women.
Methods
Retrospective cohort study of women who underwent herniorrhaphy during June 2000–December 2014 in the United States. Women aged 18–50 who underwent umbilical, incisional/ventral, or inguinal/femoral herniorrhaphy in the Truven Health Analytics MarketScan
®
Commercial Claims and Encounters database were included. Women without a hernia diagnosis or multiple/concurrent index herniorrhaphy types were excluded. Primary outcome of interest was second herniorrhaphy.
Results
Of 123,674 women, 13% had a second herniorrhaphy within 10 years; increasing age, comorbidities, childbirth, smoking, obesity, and inpatient procedure were independently associated with increased risk. Cesarean delivery before umbilical herniorrhaphy (HR 1.61, 95% CI 1.34, 1.92) and both vaginal (HR 2.57, 95% CI 1.98, 3.34) and cesarean delivery (HR 2.95, 95% CI 2.25, 3.87) after umbilical herniorrhaphy were associated with increased risk of second herniorrhaphy. Both vaginal (HR 1.66, 95% CI 1.13, 2.43) and cesarean delivery (HR 2.72, 95% CI 2.09, 3.53) after incisional/ventral herniorrhaphy and vaginal delivery after inguinal/femoral herniorrhaphy (HR 1.75, 95% CI 1.22, 2.51) were associated with increased risk of second herniorrhaphy.
Conclusions
Among reproductive-aged women, childbirth, increasing age, comorbidities, smoking, and obesity increase risk of subsequent herniorrhaphy. Risk of second herniorrhaphy is higher with cesarean delivery compared to vaginal delivery, and higher for delivery occurring after initial hernia repair compared to before. |
---|---|
ISSN: | 1265-4906 1248-9204 |
DOI: | 10.1007/s10029-019-02077-6 |