title: Randomized clinical study evaluating the impact of mesh pore size on chronic pain after Lichtenstein hernioplasty.
abstract: BACKGROUND
  The primary aim of this study was to determine whether mesh pore size influences the rate of chronic pain at 6-mo follow-up. Another aim was to evaluate the rate of foreign body feeling and quality of life after inguinal hernia repair.
  
  
  METHODS
  The patients were randomized into two study groups: the UM group received Ultrapro mesh (pore size 3-4 mm) and the OM group received Optilene LP mesh (pore size 1 mm). Pain scores were measured on a visual analog scale. The feeling of a foreign body was a yes-or-no question. Quality of life was evaluated using the Medical Outcome Study Short-Form-36 questionnaire.
  
  
  RESULTS
  A total of 67 patients in the UM group and 67 patients in the OM group were investigated 6 mo after operation. There were no significant differences in the results of the pain questionnaire between the study groups. Of the patients, 46.3% in the UM group reported pain during different activities at 6-mo follow-up versus 34.3% in the OM group (P = 0.165). The feeling of a foreign body in the inguinal region was experienced by 47.8% of the patients in the UM group and by 31.3% of the patients in the OM group at 6-mo follow-up (P = 0.052; risk ratio 1.52, 95% confidence interval: 1.00-2.37). There were no significant differences in the quality of life according to the Short-Form 36 questionnaire between the two study groups at 6-mo follow-up. In both study groups, the quality of life scores improved after operation by most dimensions.
  
  
  CONCLUSIONS
  Differences in mesh pore size did not influence the rate of chronic pain. Although there was a trend for higher rate of foreign body feeling in the study group where a mesh with larger pores was used, we failed to find an explanation for this. The pore size of meshes investigated in this study did not affect the quality of life after inguinal hernia repair. Considering the fact that the quality of life improved significantly after operation, elective repair of symptomatic inguinal hernias should be undertaken as promptly as possible.
authors.affiliation: Department of General Surgery, Surgery Clinic, Tartu University Hospital, Estonia. Electronic address: ceith.nikkolo@kliinikum.ee.
authors.forename: Ceith
authors.initials: C
authors.lastname: Nikkolo
authors.affiliation: Department of General Surgery, Surgery Clinic, Tartu University Hospital, Estonia.
authors.forename: Tiit
authors.initials: T
authors.lastname: Vaasna
authors.affiliation: Department of General Surgery, Surgery Clinic, Tartu University Hospital, Estonia.
authors.forename: Marko
authors.initials: M
authors.lastname: Murruste
authors.affiliation: Department of General Surgery, Surgery Clinic, Tartu University Hospital, Estonia.
authors.forename: Helmut
authors.initials: H
authors.lastname: Seepter
authors.affiliation: Department of General Surgery, Surgery Clinic, Tartu University Hospital, Estonia.
authors.forename: Ülle
authors.initials: Ü
authors.lastname: Kirsimägi
authors.affiliation: Department of General Surgery, Surgery Clinic, Tartu University Hospital, Estonia.
authors.forename: Urmas
authors.initials: U
authors.lastname: Lepner
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D059350:Chronic Pain / Q000209:etiology*; D005260:Female; D005547:Foreign Bodies / Q000209:etiology; D006552:Hernia, Inguinal / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000209:etiology*; D016062:Porosity; D011788:Quality of Life; D013526:Surgical Mesh / Q000009:adverse effects; D011795:Surveys and Questionnaires
keywords: Chronic pain; Foreign body feeling; Inguinal hernia; Lichtenstein hernioplasty; Pore size; Quality of life