• Willem A R Zwaans, Tim Verhagen, Luuk Wouters, Loos Maarten J A MJA Department of General Surgery, Máxima Medical Centre, Veldhoven/Eindhoven, the Netherlands., Roumen Rudi M H RMH Department of General Surgery, Máxima Medical Centre, Veldhoven/Eindhoven, the Netherlands. , and Scheltinga Marc R M MRM Department of General Surgery, Máxima Medical Centre, Veldhoven/Eindhoven, the Netherlands. .
• Department of General Surgery, Máxima Medical Centre, Veldhoven/Eindhoven, the Netherlands.
• Ann. Surg. 2018 Jun 1; 267 (6): 1028-1033.

ObjectiveThe aim of this study was to investigate long-term groin pain and inguinal hernia recurrence rates of 2 types of mesh and to describe the evolution of postoperative groin sensory disturbances.Summary Of Background DataSome patients with an inguinal hernia develop chronic pain following open mesh insertion. Previous trials comparing a semi-resorbable, self-gripping Progrip mesh with a standard sutured polypropylene mesh found conflicting results regarding recurrence rates and residual groin pain.MethodsPatients aged >18 years scheduled for open primary hernia repair were randomized to a self-gripping mesh (Progrip) or a polypropylene mesh (standard). Removal of the inguinal nerves was left to the discretion of the surgeon. Pain was measured using Visual Analogue Scale (VAS) over a 3-year period. Pain characteristics and hernia recurrences were determined using physical examination.ResultsData of 274 patients were complete (75% three-year follow-up rate). Pain steadily decreased over time in both groups in a similar fashion (moderate pain 3.7% in each group). Hyperesthesia was experienced by 2.2% and 3.7% and hypoesthesia in 12% and 19% in Progrip and standard group, respectively. One of seven Progrip patients reported a foreign body feeling versus 1 of 5 standard patients (P = 0.06). Altered skin sensations were not related to a neurectomy. Hernia recurrence rate was 11.5% in the Progrip and 5% in the standard group (P = 0.05).ConclusionsThree years after insertion of a self-gripping Progrip mesh or a sutured polypropylene mesh for an open primary inguinal hernia repair, groin pain is minimal, although altered groin skin sensations and foreign body feeling are quite common. A Progrip hernia repair is associated with a high recurrence rate.

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