[Unilateral inguinal hernia in infants: costs, risks and benefits of herniography? Results].

AIM

To assess the advantages of systématic herniography in cases of unilateral inguinal hernia in infants.

METHOD

Decision analysis presented in the first part of this article was used. A preliminary retrospective study of 348 cases as well as a literature review were utilized to determine the probabilities required in order to create and run the decision aid algorithm. Gonadic benefit was used as the health indicator.

RESULTS

For males, gonadic benefit procured by the herniography depends on the risk of strangulation in cases of groin hernia and on the frequency of testicular atrophy after inguinal hernioplasty. The evaluation of these two elements largely determines the choice of medical and surgical practices. For a 0.44% risk of post-operative testicular atrophy and a risk of strangulated hernia estimated at 20%, the cost-effectiveness ratio is FF, 199681 to save a testicle. One testicle is saved every 455 herniographies, with 24 possible post-examination complications. For female, herniography provides no gonadic benefit.

DISCUSSION

Decision analysis permits the quantification of results, leading to improved clinical judgement and facilitating the evaluation of medical practice.