Randomized clinical trial of mesh versus non-mesh primary inguinal hernia repair: long-term chronic pain at 10 years.
BACKGROUND
Open mesh or non-mesh inguinal hernia repair may influence the incidence of chronic postoperative pain differently.


METHODS
A total of 300 patients scheduled for repair of a primary unilateral inguinal hernia were randomized to non-mesh or mesh repair. The primary outcome measure was clinical outcome including persistent pain and discomfort interfering with daily activity. Long-term results at 3 years of follow-up have been published. Included here are 10-year follow-up results with respect to pain.


RESULTS
Of the 300 patients, 87 patients (30%) died and 49 patients (17%) were lost to follow-up. A total of 153 were physically examined in the outpatient clinic after a median long-term follow-up of 129 months (range, 109 to 148 months). None of the patients in the non-mesh or mesh group suffered from persistent pain and discomfort interfering with daily activity.


CONCLUSIONS
Our 10-year follow-up study provides evidence that mesh repair of inguinal hernia is equal to non-mesh repair with respect to long-term persistent pain and discomfort interfering with daily activity. An important new finding from the patient's perspective is that chronic postoperative pain seems to dissipate over time.
van Veen
Ruben N
RN
Department of Surgery, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
Wijsmuller
Arthur R
AR
Vrijland
Wietske W
WW
Hop
Wim C J
WC
Lange
Johan F
JF
Jeekel
Johannus
J
D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D006552:Hernia, Inguinal / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain; D017060:Patient Satisfaction; D013526:Surgical Mesh; D013997:Time Factors; D016896:Treatment Outcome