Sukhon Deena, Bradley Sarah E, Hallway Alex, Fry Brian, Hosea Forrest, Schoel Leah, Rubyan Michael, Shao Jenny, O'Neill Sean, Telem Dana, Ehlers Anne P
Department of Surgery, Michigan Medicine, 1500 E. Medical Center Drive, Ann Arbor, MI, 48109, USA.
Center for Healthcare Outcomes & Policy (CHOP), University of Michigan, Ann Arbor, MI, USA.
Surg Endosc. 2025 Jan;39(1):594-603. doi: 10.1007/s00464-024-11255-2. Epub 2024 Oct 25.
Thousands of females undergo inguinal hernia repair annually, yet females have been excluded from prior clinical trials evaluating inguinal hernia repairs. Research shows females face worse outcomes after hernia repair compared to males, including higher recurrence rates, increased chronic pain, and limited data to guide treatment. Prospective studies focused on optimizing outcomes for females are critically needed. Prior to conducting such trials, it is essential to obtain preliminary data from female participants to ensure that the studies are designed appropriately to address their priorities and improve sex disparities in outcomes.
Semi-structured qualitative interviews were conducted between July 7 and December 31, 2023, with 34 females evaluated for groin hernia. Interviews were conducted via Zoom at an academic medical center. The discussions aimed to explore the challenges in diagnosing hernias, the considerations for selecting treatment options, and the priorities for future research. The transcripts were analyzed using descriptive content analysis, facilitated by MAXQDA software.
Diagnostic challenges included delayed recognition due to underappreciation of female hernias. Participants desired greater familiarity with hernias and treatment options from providers. For surgical decisions, fear of complications drove some towards surgery, while others prioritized avoiding recovery time for asymptomatic hernias. Participants called for research on female-specific risk factors, pain experiences, recovery impacts, and non-operative approaches. The majority of participants agreed or considered participating and serving as an advisor in a future study.
Females with hernia face sex-based disparities in diagnosis and treatment. Improving provider awareness and developing guidelines are needed. This qualitative study identifies key areas for future research to optimize person-centered hernia care for females based directly on personal perspectives and priorities, laying the groundwork for prospective trials aimed at improving outcomes.
每年有成千上万的女性接受腹股沟疝修补术，但在以往评估腹股沟疝修补术的临床试验中，女性被排除在外。研究表明，与男性相比，女性疝修补术后的结局更差，包括更高的复发率、慢性疼痛增加以及指导治疗的数据有限。迫切需要开展前瞻性研究，以优化女性患者的治疗结局。在进行此类试验之前，必须从女性参与者那里获取初步数据，以确保研究设计合理，能够解决她们的优先事项并改善结局方面的性别差异。
2023年7月7日至12月31日期间，对34名接受腹股沟疝评估的女性进行了半结构化定性访谈。访谈在一家学术医疗中心通过Zoom进行。讨论旨在探讨疝诊断中的挑战、治疗方案选择的考虑因素以及未来研究的重点。使用MAXQDA软件辅助进行描述性内容分析，对访谈记录进行了分析。
诊断挑战包括由于对女性疝认识不足而导致的诊断延迟。参与者希望医疗服务提供者对疝和治疗方案有更深入的了解。在手术决策方面，对并发症的恐惧促使一些人选择手术，而另一些人则优先考虑避免无症状疝的恢复时间。参与者呼吁开展针对女性特定危险因素、疼痛经历、恢复影响和非手术方法的研究。大多数参与者同意或考虑参与未来的研究并担任顾问。
患有疝的女性在诊断和治疗上面临基于性别的差异。需要提高医疗服务提供者的认识并制定指南。这项定性研究确定了未来研究的关键领域，以便直接根据个人观点和优先事项优化以患者为中心的女性疝护理，为旨在改善结局的前瞻性试验奠定基础。
