Chronic groin sepsis following tension-free inguinal hernioplasty

Background: Chronic groin sepsis requiring mesh removal is said to be a rare complication of tension-free inguinal hernioplasty. The aim of this study was to determine the number of surgeons performing tension-free inguinal hernioplasty in the West of Scotland and assess the frequency with which chronic groin sepsis was encountered. Methods: A questionnaire was sent to all consultant surgeons performing inguinal hernia repair in the region and follow-up of patients with chronic groin sepsis following tension-free inguinal hernioplasty was undertaken. Results: Of 80 consultants who replied to the questionnaire, 79 were performing tension-free hernioplasty. Of these, 76 were performing only open repairs while three were also undertaking laparoscopic repairs. Sixteen consultants reported 20 patients with groin sepsis after mesh repair. Twelve patients were traced; eight had chronic sinuses and four had groin abscesses. The median interval between repair and presentation was 4 months (range from 2 weeks to 39 months). All have required complete (11 patients) or partial (one) removal of mesh to resolve the symptoms. Conclusion: Tension-free inguinal hernioplasty has become the operation of choice for surgeons in the region. Chronic groin sepsis may be more frequent than reported previously. Complete removal of mesh is required to treat this condition.