title: Comparison of polypropylene versus polyester mesh in the Lichtenstein hernia repair with respect to chronic pain and discomfort.
abstract: BACKGROUND
  Inguinal hernias are the most common operative procedure performed by general surgeons, and tension-free mesh techniques have revolutionized the procedure. While hernia recurrence rates have decreased, chronic postoperative pain has become recognized more widely. New mesh products offer the potential to decrease pain without compromising recurrence rates. Polyester mesh is a softer material than traditional polypropylene and may offer the benefit of causing less postoperative pain and improved quality of life.
  
  
  METHODS
  Prospective, single-blind, randomized controlled trial involving 78 patients assigned to receive Lichtenstein type repair with either polyester (n = 39) or polypropylene (n = 39) mesh. Attempt was made to identify ilioinguinal, iliohypogastric, and genitofemoral nerves intraoperatively and document their handling. Patients were interviewed and examined preoperatively and postoperatively at 2 weeks and 3 months. Inguinal Pain Questionnaire (IPQ) and VAS scores were obtained and analyzed using two sample t test for continuous variables and Chi-square test for categorical variables.
  
  
  RESULTS
  VAS scores at 3 months were 0.46 for the polyester group versus 0.56 for the polypropylene group (P = 0.6727). At 3 months, 82.3% of the polyester and 76.4% of the polypropylene group had VAS = 0 (P = 0.5486). There was no significant difference between the two groups' VAS scores at 3 months. IPQ did not show any difference between the two groups with the exception of "catching or pulling" being reported in 34.3% of polyester and 5.7% of polypropylene groups (P = 0.0028).
  
  
  CONCLUSIONS
  Polyester mesh does not decrease the amount of chronic pain at 3 months. Outcomes with polyester mesh are comparable to polypropylene mesh for Lichtenstein inguinal hernia repair with regards to postoperative pain and quality of life. The sample size in this study was small and limits the significance of the results. Further studies are needed to find the optimal mesh for inguinal hernia repair.
authors.affiliation: Department of Surgery, Scott and White Memorial Hospital, 2401 South 31st Street, Temple, TX 76508, USA.
authors.forename: B
authors.initials: B
authors.lastname: Sadowski
authors.forename: J
authors.initials: J
authors.lastname: Rodriguez
authors.forename: R
authors.initials: R
authors.lastname: Symmonds
authors.forename: J
authors.initials: J
authors.lastname: Roberts
authors.forename: J
authors.initials: J
authors.lastname: Song
authors.forename: M Hasan
authors.initials: MH
authors.lastname: Rajab
authors.forename: C
authors.initials: C
authors.lastname: Cummings
authors.forename: B
authors.initials: B
authors.lastname: Hodges
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D059350:Chronic Pain / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006119:Groin / Q000294:innervation; D006552:Hernia, Inguinal / Q000601:surgery; D059685:Herniorrhaphy / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000209:etiology*; D059348:Peripheral Nerve Injuries / Q000150:complications*; D011091:Polyesters / Q000009:adverse effects*; D011126:Polypropylenes / Q000009:adverse effects*; D016037:Single-Blind Method; D013526:Surgical Mesh / Q000009:adverse effects*; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D011091:Polyesters; D011126:Polypropylenes