A single-surgeon randomized trial comparing three meshes in lichtenstein hernia repair: 2-and 5-year outcome of recurrences and chronic pain

Background: Chronic pain may be a major long-term problem related to mesh material and operative trauma in inguinal hernioplasty. Study design: Lichtenstein hernioplasty was performed under local anaesthesia in 312 patients by the same surgeon and technique between 2003 and 2005. The patients were randomized to receive a partly absorbable polypropylene-polyglactin mesh (Vypro II (R) 50 g/m(2), 104 hernias), a lightweight polypropylene mesh (Premilene Mesh LP (R) 55 g/m(2), 107 hernias) or a conventional densely woven polypropylene mesh (Premilene (R) 82 g/m(2), 101 hernias). The 2- and 5-year recurrences and pain scores were analysed. Results: Patient's characteristics and the mean duration of operation (30-32 min) were similar between the three groups. After two years, there were 6 recurrences (2 in each group) of which 3 patients were re-operated. A feeling of a foreign body and sensation of pain were comparable with all meshes. After five years, overall recurrence rate was 10/312 (3.2%) with only 4 re-operations. A feeling of a foreign body (6.5-8.1%), chronic pain (13-23%) as well as use of analgesics (0-2.9%) were similar in all groups. Conclusion: There were no statistical differences between the three meshes in pain, a feeling of a foreign body or use of analgesics after 5 years of Lichtenstein hernioplasty, when the same surgeon operated all patients with exactly the same surgical technique. Clinical Trial Register: NCT01295437. (C) 2012 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.