Analytical Study of Hernia Recurrence After Inguinal Herniorrhaphy and Its Risk Factors at University of Port Harcourt Teaching Hospital

Inguinal hernia recurrence following herniorrhaphy is a clinically significant surgical complication with major implications for quality of life and health system cost, yet recurrence rates and their independent predictors at South South Nigerian teaching hospitals are not well characterised. This study analytically examines the recurrence rate and risk factors for inguinal hernia recurrence at the University of Port Harcourt Teaching Hospital, Rivers State. A retrospective cohort design is applied to records of 350 adult patients who underwent primary inguinal herniorrhaphy between 2015 and 2020 and attended at least one follow-up visit by 2023. Recurrence is defined as symptomatic or examination-confirmed re-emergence of hernia at the operative site. Risk factors analysed include patient age, BMI, ASA grade, bilateral versus unilateral repair, mesh versus non-mesh technique, wound infection, surgeon grade, and follow-up duration. Cox regression analysis in SPSS models time-to-recurrence and identifies independent predictors. Available hernia surgery literature from South South Nigeria identifies non-mesh tissue repair and postoperative wound infection as the strongest modifiable predictors of recurrence, with cumulative five-year recurrence rates of 10 to 20 percent for non-mesh repairs. The European Hernia Society guidelines on inguinal hernia repair provide the normative management framework. Findings will support the surgical unit's adoption of standardised mesh hernioplasty protocols. Keywords: inguinal hernia recurrence, herniorrhaphy, risk factors, Port Harcourt, South South Nigeria.