OC-043 SYSTEMATIC REVIEW AND GUIDELINES FOR MANAGEMENT OF SCROTAL INGUINAL HERNIAS

Abstract Introduction 6% of all inguinal hernias are scrotal in high-resource countries rising to 67% low-resource countries. This represents a heavy disease burden on relatively young men during their most productive period life. Despite limited evidence these guidelines aim improve treatment for hernia patients. Methods After developing 19 key questions systematic literature review was performed Statements and recommendations were formulated. Online Consensus meetings with 25 HerniaSurge members organised voting grading Recommendations as “strong” (recommendations) or “weak” (suggestions) by consensus, some cases upgraded. Results 23 studies selected. Scrotal is defined an which has descended into causes any distortion. A new classification proposed based size, SI=upper third thigh, SII=middle thigh SIII=lower below. IR denotes irreducibility. weak antibiotic prophylaxis urinary catheterization recommended (upgraded) complex (S2–3) due prolonged operative time. repairs have higher associated morbidity mortality compared non-complex groin repairs. Open anterior (mesh) approach commonest technique suture techniques low resource TAPP resulted less conversion open TEP. Conclusions Although scarce often low-quality management recommend more tailored approaches better surgical outcomes available resources appropriate skills provide impetus future research where adoption will enable meaningful comparison different sizes.