Laparoscopic bilateral groin hernia repair with one large self-fixating mesh: prospective observational study with patient-reported outcome of urological symptoms and EuraHS-QoL scores



Laparoscopic bilateral inguinal hernia repair may be completed with one large self-fixating mesh crossing the midline. No studies have investigated in detail whether preperitoneal mesh placement induces temporary or more lasting urinary symptoms.


Urinary and hernia-related symptoms were evaluated preoperatively and postoperatively at 1, 3 and 12 months using the ICIQ-MLUTS questionnaire and EuraHS-QoL score in patients undergoing bilateral inguinal hernia repair.


One hundred patients were included. Voiding symptoms and bother scores were unchanged at 1 or 3 months, but there was significant improvement at 12 months compared with preoperative findings (symptoms P < 0.001; bother score P < 0.01). Incontinence symptoms improved at 1 month (P < 0.05) but not at 3 or 12 months, with a bother score significantly improved at 1 month (P < 0.01) and 12 months (P < 0.01). Diurnal and nocturnal frequency did not change significantly postoperatively, but 12 months nocturnal bother score was decreased (P < 0.05). EuraHS-QoL scores showed statistical significant improvement in all three domains for all measurements at the different follow-up moments compared to previous measurements. Postoperative symptoms were improved at 12 months, compared with preoperative pain scores (− 6.1), restriction of activity (− 10.1) and cosmetic scores (− 4.7) These findings were statistically significant (P < 0.001). At 12 months, there were no patients with severe discomfort (score ≥ 5) for any of the three domains. No recurrences were diagnosed with 95% clinical follow-up at 12 months.


Laparoscopic bilateral groin hernia repair with one large preperitoneal self-fixating mesh did not cause new urinary symptoms and demonstrated significant improvement in voiding symptoms at 12 months. Incontinence and nocturnal bother score were significantly improved.

Clinical trial registry identifier NCT02525666.

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Correspondence to Filip Muysoms.

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Dr. Muysoms reports having received research grants from Medtronic, Dynamesh and received speakers honorarium from Medtronic, Bard-Davol, Dynamesh, Intuitive Surgical and received consultancy fees from Medtronic, Intuitive Surgical, CMR Surgical. Drs. Dewulf, Kyle-Leinhase, Baumgartner, Ameye, Defoort and Pletinckx have no conflicts of interest or financial ties to disclose.

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This manuscript was written in accordance with the STROBE statement: Strengthening the reporting of observational studies in epidemiology. von Elm E et al. BMJ. 2007; 335:806-8.

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Muysoms, F., Dewulf, M., Kyle-Leinhase, I. et al. Laparoscopic bilateral groin hernia repair with one large self-fixating mesh: prospective observational study with patient-reported outcome of urological symptoms and EuraHS-QoL scores. Surg Endosc 34, 920–929 (2020).

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  • Inguinal hernia
  • Groin hernia
  • Laparoscopic surgery
  • Urinary symptoms
  • Quality of Life
  • Self-fixating mesh
  • EuraHS-QoL score