Cystodistension: certainly no standards and possibly no benefits—survey of UK practice

Introduction and hypothesis  

Cystodistension is not a standardised procedure; however, it is being used for various indications.     

Planned inguinal herniorrhaphy but no hernia sac?

Background. Planned inguinal herniorrhaphy may present a clinical dilemma when no hernia is found. No large-scale data are available on the incidence of this problem, and, therefore, no recommendations exist for choice of surgical intervention. Material and methods. Data were extracted from the Danish Hernia Database covering the interval from 1 January 1998–5 April 2002, and included 42,356 groin hernia repairs. Results. No hernia was found in 313 cases (0.74%). These patients were divided into three groups (lipomas, no pathology, and a weak abdominal wall) and analysed according to surgical technique. There were 11 reoperations (3.5%) of which three were femoral and eight inguinal hernias, without differences between type of initial operation (herniorrhaphy or no herniorrhaphy). Conclusion. This study of 42,356 groin hernia repairs showed that in 313 patients (0.74%), no hernia was found. Recurrences did not occur with higher frequency in patients receiving no repair. Based on these data and the risk of chronic postherniorrhaphy pain, we suggest that no repair be performed when no inguinal hernia is found during planned inguinal herniorrhaphy.