Bilateral giant inguinoscrotal Hernia: psychosocial issues and a new classification.

BACKGROUND Bilateral giant inguinoscrotal hernias pose challenging psychosocial problems to the patient. The engulfed phallus and hernia size are socially embarrassing and may make penetration during coitus increasingly difficult and uncomfortable. This paper presents a classification and the psychosocial aspects of bilateral giant inguinoscrotal hernias. METHODS A prospective study of patients with bilateral giant inguinoscrotal hernia in which the phallus was completely engulfed by the swelling, managed by this author between 2002 and 2011 in both urban and rural practice in Nigeria and Sierra Leone was reviewed and analyzed using a simple frequency distribution. RESULTS Eleven patients with bilateral giant inguinoscrotal hernias were reviewed. Age range 63-86 years. Mean age 73.73 (± 6.96SD) years. The reason for delayed presentation was financial constraint. Six patients (54.55%) presented due to continuous refusal of coitus by their partners. Sexual satisfaction was poor in all the patients (100.00%). All the patients (100.00%) had poor self-esteem and poor socialization habits as a result of continuous ridicule from peers and colleagues. CONCLUSION To improve quality of life of the elderly, there is the need for early awareness campaigns and provision of improved access to free surgical health care services particularly in rural African communities.