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

Chronic pain may be a major long-term problem related to mesh material and operative trauma in inguinal hernioplasty. 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(®) 50 g/m(2), 104 hernias), a lightweight polypropylene mesh (Premilene Mesh LP(®) 55 g/m(2), 107 hernias) or a conventional densely woven polypropylene mesh (Premilene(®) 82 g/m(2), 101 hernias). The 2- and 5-year recurrences and pain scores were analysed. 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. 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.