Groin hernia repair in young males: mesh or sutured repair?
BACKGROUND
Large-scale data for the optimal inguinal hernia repair in younger men with an indirect hernia is not available. We analysed nationwide data for risk of reoperation in younger men after a primary repair using a Lichtenstein operation or a conventional non-mesh hernia repair.


METHODS
Prospective recording of all inguinal hernia repairs from 1 January 1998 to 31 December 2005 in the national Danish Hernia Database, using reoperation rate as a proxy for recurrence. We included only men between the age of 18 and 30 years with a primary repair of a primary indirect inguinal hernia.


RESULTS
A primary sutured repair was performed in 1,120 men (median age 23 years, range 18-30) and a Lichtenstein mesh repair in 2,061 young men (24 years, range 18-30) (total 3,181 patients). The observation time after conventional hernia repair was median 62 months (range 0-96) and 41 months (range 0-96) after a Lichtenstein repair. The cumulative incidence of reoperation at 5 years was 1.6% (Lichtenstein) versus 3.9% (sutured repair), while overall reoperation rates were almost three-fold as high after a sutured repair (39 reoperations, overall reoperation rate = 3.5%) compared to a Lichtenstein repair (24 reoperations, overall reoperation rate = 1.2%; P = 0.0003).


CONCLUSIONS
Lichtenstein repair for an indirect inguinal hernia reduces the risk of recurrence in young men between the age of 18 and 30 years compared with a sutured repair. The use of a Lichtenstein mesh repair in young males must be balanced against the risk of chronic pain.
Bisgaard
T
T
Department of Surgery, Køge Sygehus, Køge, Denmark. thuebisgaard@tdcadsl.dk
Bay-Nielsen
M
M
Kehlet
H
H
D000293:Adolescent; D000328:Adult; D005500:Follow-Up Studies; D006119:Groin / Q000601:surgery; D006552:Hernia, Inguinal / Q000601:surgery*; D006801:Humans; D008297:Male; D011446:Prospective Studies; D055502:Secondary Prevention; D013526:Surgical Mesh; D013536:Suture Techniques / Q000295:instrumentation*; D013537:Sutures; D016896:Treatment Outcome; D014945:Wound Healing; D055815:Young Adult
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