VOLUMETRIC CLASSIFICATION OF INGUINOSCROTAL SWELLINGS.

Background: External hernias and scrotal swellings are diverse in presentation and are described in many subjective ways. Aim: To create an objective classification of inguinoscrotal swellings in the rural setting. Patients and methods: It was a prospective study on the measurement of inguinoscrotal swellings volume/contents in a cohort of surgical patients in a provincial general hospital in the north of Sierra Leone over a three-year period. For inguinal hernias and other scrotal swellings, the volume ranges of 0- 500ml were used in the classification; for femoral and other external hernias which generally do not reach 'huge' sizes, the volume ranges of 0-100 ml were used. Results: A total of 962 external hernias and hydroceles were classified over a 3- year period. Most, 610 (63.4%) were inguino-scrotal hernias, others were hydroceles, 303 (31.0%) and femoral hernias, 42 (4.3%). The remaining small number consisted of umbilical (4) and epigastric (3) hernias. For the common conditions of hydroceles, inguinal and femoral hernias, about 50% were 'small', more than 40% were 'large', the rest were giant. The same findings were true for epigastric and umbilical hernias. Conclusion: Using the scale that we adopted, majority of the groin hernias and hydroceles were in the small and large categories with a few giant varieties. Volumetric-based classification of hernias and hydroceles can help surgeons communicate more clearly based on standard rather than arbitrary ascription of descriptive terminologies to these very common surgical entities.