title: UltraPro Hernia System, Prolene Hernia System and Lichtenstein for primary inguinal hernia repair: 3-year outcomes of a prospective randomized controlled trial.
abstract: Chronic pain and discomfort are common after inguinal hernia repair (IHR). In this study, results from a 3-year follow-up from a randomized controlled study comparing three different mesh repairs for postoperative pain, discomfort, Quality of Life (QoL) and patient satisfaction are reported.
  
  
  
  Between November 1, 2006 and January 31, 2009, 309 men, who underwent day surgery for primary unilateral inguinal hernia under local anesthesia, were randomized to three different mesh repairs; UltraPro Hernia System (U), Prolene Hernia System (P) and Lichtenstein procedure (L).
  
  
  
  Preoperatively, there were no differences between groups regarding demographics, symptoms, inguinal pain or QoL (SF-36 and a hernia-specific questionnaire). Operating time, postoperative pain, complications and time to full recovery were similar. At 36 months, 21 patients indicated pain [L, n = 6, P, n = 6 and U, n = 9; VAS (median (IQR)): L 0.4 (0.2-1.7), P 0.2 (0.1-2.3) and U 1.6 (0.7-4.6), p = ns]. Physical QoL was reduced in all groups before surgery and was similarly increased to normal levels after 3 months without further changes throughout the study. Although 92 % of participants were satisfied, sixteen percent reported any discomfort from the groin (ns between groups). Five recurrences were reported (L, n = 2, P, n = 1 and U, n = 2, p = ns).
  
  
  
  After 3 years of follow-up, all three procedures provided equally good results regarding, pain, discomfort and QoL and could therefore be recommended for primary IHR in LA.
authors.affiliation: Department of Clinical Sciences, Danderyds Hospital, Karolinska Institutet, Stockholm, Sweden. jesper.magnusson@erstadiakoni.se.|Department of Surgery, Ersta Hospital, Stockholm, Sweden. jesper.magnusson@erstadiakoni.se.
authors.forename: J
authors.initials: J
authors.lastname: Magnusson
authors.affiliation: Department of Clinical Sciences, Danderyds Hospital, Karolinska Institutet, Stockholm, Sweden.|Department of Surgery, Ersta Hospital, Stockholm, Sweden.
authors.forename: J
authors.initials: J
authors.lastname: Nygren
authors.affiliation: Department of Clinical Sciences, Danderyds Hospital, Karolinska Institutet, Stockholm, Sweden.|Department of Surgery, Danderyds Hospital, Stockholm, Sweden.
authors.forename: U O
authors.initials: UO
authors.lastname: Gustafsson
authors.affiliation: Department of Clinical Sciences, Danderyds Hospital, Karolinska Institutet, Stockholm, Sweden.|Department of Surgery, Ersta Hospital, Stockholm, Sweden.
authors.forename: A
authors.initials: A
authors.lastname: Thorell
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D004311:Double-Blind Method; D005500:Follow-Up Studies; D006552:Hernia, Inguinal / Q000601:surgery*; D059685:Herniorrhaphy / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain; D017060:Patient Satisfaction; D011446:Prospective Studies; D011788:Quality of Life; D013526:Surgical Mesh; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult
keywords: Inguinal hernia; Lichtenstein; PHS; Pain; Quality of life; SF-36; UHS