Essential Surgery Chapter 9: Hernia and Hydrocele

Groin hernia and hydrocele are two of the most common surgical conditions globally. Although the surgical care for these conditions is cost-effective, many people do not have access to hernia repair and hydrocelectomy. These essential operations must be prioritized and integrated into primary healthcare delivery systems in lowand middle-income countries. INTRODUCTION Groin hernia and hydrocele are two of the most common surgical conditions globally. In this chapter, we summarize the literature on the pathogenesis, clinical presentation, and treatment for groin hernia and hydrocele, focusing on unique clinical characteristics and management strategies for these conditions in lowand middle-income countries (LMICs). We present our estimation of the global and regional burden of disease from groin hernia, the first of its kind in the literature. In addition, we highlight the existing data on the cost-effectiveness of surgical treatment for groin hernia and hydrocele. We document the successful global efforts of Operation Hernia and the Global Programme to Eliminate Lymphatic Filariasis (GPELF) in combating hernia and lymphatic filariasis (a common cause of hydrocele in LMICs), respectively. Groin hernia repair and hydrocelectomy are cost-effective curative therapies that can improve quality of life. In addition, herniorrhaphy can prevent life-threatening complications associated with groin hernia.