What's Up in Surgery? — Numbers · Paediatric Inguinal Hernia & Hydrocele

Card 1 of 23: Testicular atrophy after an incarceration episode

QualifiedPaediatric Inguinal Hernia & Hydrocele 📖 Ch 5 · Abdominal Wall & Hernia Surgery

PED-HRN-COMP-01

Testicular atrophy after an incarceration episode

Atrophic testis following incarcerated hernia (historical series)

The number is concealed — recall it first, then flip the card and grade yourself honestly.

PED-HRN-COMP-01 · Testicular atrophy after an incarceration episode

~30%

historical, single-centre, pre-modern-pathway

Qualified. Single source, or abstract-level verification — provisional

Applies to — the population, exactly as printed

Infants with incarcerated hernia (1984 Irish series, as cited by Zamakhshary 2008, ref 3)

Basis — n / evidence base

Puri, Guiney & O'Donnell, *J Pediatr Surg*, 1984;19:44-6

Evidence tier (the registry's wording)

Single-centre series, 1984

Dispute — the sources disagree

Puri et al. (via Zamakhshary 2008) · ~30% · Infants in whom incarceration had already occurred (1984 series) · 1984
Olesen et al. (SR) · 1% · All children in awaiting-surgery cohorts (incarceration itself ~7–12% of them) · 2019
Ein et al. · 0.3% · Children after elective repair · 2006

Why they differ

The denominators are radically different: conditional on incarceration occurring (30% historically) ≠ inclusive of all waiters (1%) ≠ after a quiet planned repair (0.3%). There is no arithmetical conflict between them; the conflict is born only when any one of them is stripped of its denominator.

Adopted

The three are always published together with their denominators written, and in the parents' card they are presented in qualitative wording ('incarceration may harm the testicle — and speed and the planned operation are the protection') without headlining the 30%.

Justification

Deleting any layer misleads; the historical figure is kept because no newer pooled estimate exists for this specific conditional denominator — with it tagged '1984' wherever it appears (sources >10 years rule: the reasoning is written here).

Sources

Puri et al. 1984, cited in Zamakhshary 2008 (full text)

Grade yourself — spaced repetition

Verification stamp: 🟡 Qualified · Registry audit 2026-11-06 · Pending triple review · Surgery Code registry — family file 08 (08-paediatric-hernia-hydrocele.md), coded unit; registry audit 2026-11-06. Permalink to this card