Hernia

, Volume 14, Issue 3, pp 253–258

Randomised clinical trial comparing lightweight mesh with heavyweight mesh for inguinal hernioplasty

  • C. Nikkolo
  • U. Lepner
  • M. Murruste
  • T. Vaasna
  • H. Seepter
  • T. Tikk
Original Article

Abstract

Purpose

The aim of the present randomised clinical study was to compare the incidence of post-operative chronic groin pain and the feeling of a foreign body after inguinal hernioplasty with lightweight (LW) and heavyweight (HW) mesh, as well as to evaluate the patient’s quality of life after inguinal hernia repair.

Methods

A total of 135 patients were randomised into the HW mesh group (66 patients) and the LW mesh group (69 patients). A tension-free repair using the Lichtenstein technique was performed on all patients. Pain scores were measured on a visual analogue scale. To evaluate the patient’s quality of life, the Medical Outcomes Study Short-Form (SF) 36 questionnaire was completed by the patient.

Results

There were significantly more patients with pain at rest in the HW mesh group than in the LW mesh group at 6 months follow-up (6.3 vs. 0%, P = 0.038). The feeling of a foreign body at the operation site was experienced by 32.8% of the patients in the HW group and by 20.9% of the patients in the LW group after 6 post-operative months (P = 0.123). There were no significant differences in any dimension of quality of life on the SF36 between the two study groups 6 months after surgery.

Conclusions

Our study shows that, compared with HW mesh, LW mesh has some advantages in reducing chronic groin pain at the operation site after inguinal hernioplasty. According to our study, there was no difference in the feeling of a foreign body and in the quality of life between the two study groups.

Keywords

Inguinal hernia Lightweight mesh Lichtenstein hernioplasty Chronic pain Quality of life 

References

  1. 1.
    van Veen RN, Wijsmuller AR, Vrijland WW, Hop WC, Lange JF, Jeekel J (2007) Long-term follow-up of a randomized clinical trial of non-mesh versus mesh repair of primary inguinal hernia. Br J Surg 94:506–510CrossRefPubMedGoogle Scholar
  2. 2.
    Mokete M, Earnshaw JJ (2001) Evolution of an inguinal hernia surgery practice. Postgrad Med J 77:188–190CrossRefPubMedGoogle Scholar
  3. 3.
    EU Hernia Trialists Collaboration (2000) Mesh compared with non-mesh methods of open groin hernia repair: systematic review of randomized controlled trials. Br J Surg 87:854–859CrossRefGoogle Scholar
  4. 4.
    Massaron S, Bona S, Fumagalli U, Battafarano F, Elmore U, Rosati R (2007) Analysis of post-surgical pain after inguinal hernia repair: a prospective study of 1,440 operations. Hernia 11:517–525CrossRefPubMedGoogle Scholar
  5. 5.
    Grant AM, Scott NW, O’Dwyer PJ (2004) Five-year follow-up of a randomized trial to assess pain and numbness after laparoscopic or open repair of groin hernia. Br J Surg 91:1570–1574CrossRefPubMedGoogle Scholar
  6. 6.
    Aasvang EK, Bay-Nielsen M, Kehlet H (2006) Pain and functional impairment 6 years after inguinal herniorrhaphy. Hernia 10:316–321CrossRefPubMedGoogle Scholar
  7. 7.
    Nienhuijs S, Staal E, Strobbe L, Rosman C, Groenewoud H, Bleichrodt R (2007) Chronic pain after mesh repair of inguinal hernia: a systematic review. Am J Surg 194:394–400CrossRefPubMedGoogle Scholar
  8. 8.
    Kumar S, Wilson RG, Nixon SJ, Macintyre IM (2002) Chronic pain after laparoscopic and open mesh repair of groin hernia. Br J Surg 89:1476–1479CrossRefPubMedGoogle Scholar
  9. 9.
    Ferzli GS, Edwards E, Al-Khoury G, Hardin RM (2008) Postherniorrhaphy groin pain and how to avoid it. Surg Clin North Am 88:203–216CrossRefPubMedGoogle Scholar
  10. 10.
    O’Dwyer PJ, Kingsnorth AN, Molloy RG, Small PK, Lammers B, Horeyseck G (2005) Randomized clinical trial assessing impact of a lightweight or heavyweight mesh on chronic pain after inguinal hernia repair. Br J Surg 92:166–170CrossRefPubMedGoogle Scholar
  11. 11.
    Post S, Weiss B, Willer M, Neufang T, Lorenz D (2004) Randomized clinical trial of lightweight composite mesh for Lichtenstein inguinal hernia repair. Br J Surg 91:44–48CrossRefPubMedGoogle Scholar
  12. 12.
    Klinge U, Klosterhalfen B, Müller M, Schumpelick V (1999) Foreign body reaction to meshes used for the repair of abdominal wall hernias. Eur J Surg 165:665–673CrossRefPubMedGoogle Scholar
  13. 13.
    Koch A, Bringman S, Myrelid P, Smeds S, Kald A (2008) Randomized clinical trial of groin hernia repair with titanium-coated lightweight mesh compared with standard polypropylene mesh. Br J Surg 95:1226–1231CrossRefPubMedGoogle Scholar
  14. 14.
    Page B, Paterson C, Young D, O’Dwyer PJ (2002) Pain from primary inguinal hernia and the effect of repair on pain. Br J Surg 89:1315–1318CrossRefPubMedGoogle Scholar
  15. 15.
    International Association for the Study of Pain (1986) Classification of chronic pain. Descriptions of chronic pain syndromes and definitions of pain terms. Prepared by the International Association for the Study of Pain, Subcommittee on Taxonomy. Pain Suppl 3:S1–S226Google Scholar
  16. 16.
    Aasvang E, Kehlet H (2005) Chronic postoperative pain: the case of inguinal herniorrhaphy. Br J Anaesth 95:69–76CrossRefPubMedGoogle Scholar
  17. 17.
    Śmietański M (2008) Randomized clinical trial comparing a polypropylene with a poliglecaprone and polypropylene composite mesh for inguinal hernioplasty. Br J Surg 95:1462–1468CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • C. Nikkolo
    • 1
  • U. Lepner
    • 1
  • M. Murruste
    • 1
  • T. Vaasna
    • 1
  • H. Seepter
    • 1
  • T. Tikk
    • 1
  1. 1.Clinic of SurgeryTartu University HospitalTartuEstonia

Personalised recommendations