A single-surgeon randomized trial comparing three composite meshes on chronic pain after Lichtenstein hernia repair in local anesthesia

Background: Chronic pain may be a long-term problem related to operative trauma and mesh material in Lichtenstein hernioplasty. Study design: Inguinal hernioplasty was performed under local anesthesia in 228 patients (232 hernias) in day-case surgery by the same surgeon and exactly by the same surgical technique. The patients were randomized to receive either a partly absorbable polypropylene-polyglactin mesh (Vypro IIR 50 g/m2, 79 hernias), a lightweight polypropylene mesh (Premilene Mesh LPR 55 g/m2, 75 hernias) or a conventional densely woven polypropylene mesh (PremileneR 82 g/m2, 78 hernias). Pain, patients discomfort and recurrences of hernias were carefully followed at days 1, 7, 1 month, 1 and 2 years after surgery. Results: The duration of operation (29-33 min) and the amount of local anesthetic (55-57 ml) were similar in the three groups. Two wound infections and four hematomas were detected with no difference between the meshes. Immediate pain reaction up to 1 month was statistically equal among the three meshes. After 2 years of follow-up, there were five recurrences (two in the Vypro group, one in the Premilene LP and two in the Premilene). A feeling of a foreign body, sensation of pain and patient's discomfort were similar with all meshes. Conclusion: There was no difference of pain and quality of life among a conventional polypropylene mesh, lightweight mesh or partly absorbable mesh in 2 years of follow-up, when the same surgeon operated on all patients with exactly the same technique. © Springer-Verlag 2007.