Manual Reduction Technique for Incarcerated Inguinoscrotal Hernia in Boys

Abstract

BACKGROUND: Incarcerated inguinoscrotal hernia in children is a serious and relatively common complication (5.2%–24%) that can be life-threatening. Elective surgical repair is considered the most favorable option. Several manual reduction techniques have been proposed as part of conservative management; however, these methods have certain limitations and drawbacks.

AIM: The study aimed to evaluate the advantages of a proposed manual reduction technique for incarcerated inguinoscrotal hernia in boys.

METHODS: Between 2020 and 2023, 67 children with incarcerated inguinal hernias were admitted to the surgical department. Inclusion criteria comprised boys with incarcerated inguinoscrotal hernias of less than 12 hours’ duration, without signs of complications involving the scrotal organs or abdominal cavity. The main group included 17 children who underwent conservative therapy in combination with the new manual reduction technique. The control group consisted of 23 patients who received conservative therapy with the conventional method of gentle compression of the scrotum using all fingers. Following premedication and manual shaping the hernial sac into a funnel—its narrowest point matching the diameter of the external inguinal ring—the funnel was stabilized circumferentially with the fingers of one hand, whereas the other hand gently compressed the remaining part of the sac toward the abdominal cavity until spontaneous reduction of hernia contents was achieved.

RESULTS: Comparison of the parameters of the conventional and the new manual reduction techniques for incarcerated inguinoscrotal hernia revealed significantly higher effectiveness of conservative therapy and a shorter procedure time in the main group using the new method (p < 0.05). The degree of compression applied to the hernial sac in the main group was also lower, which significantly reduced the risk of trauma during the procedure.

CONCLUSION: The proposed manual reduction method for incarcerated hernias in boys demonstrated higher efficacy, faster execution, and reduced trauma risk.

Keywords

incarcerated inguinoscrotal hernia / manual reduction technique / hernia reduction / boys

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