Prospective Multicenter Blinded Randomized Study Comparing PP and PVDF Mesh Implants in Lichtenstein Procedure with Respect to Pain and Recurrence - Abstract
Introduction: In the past decades tension-free inguinal hernia repair using prosthetic meshes has become the procedure of choice. Recurrence rates could be reduced, but still remain one of the major complications. Another major problem is pain of which both acute and chronic pain can influence the patients’ quality of life directly.
Material and methods: We conducted a single blinded multicenter randomized trial with 164 patients treated for primary bilateral inguinal hernia with a total follow-up period of one year. The open tension-free Lichtenstein technique as described by Amid was used as standardized procedure. In each patient, we used two different meshes. The Surgipro® is composed of polypropylene (PP) and the DynaMesh®-LICHTENSTEIN of polyvinylidene fluoride (PVDF). This approach allowed us to investigate pain, chronic pain and other postoperative complications in dependence of the used mesh.
Results: Overall, both biomaterials performed well over the full follow-up period of one year, but the DynaMesh-LICHTENSTEIN was significantly better in terms of late postoperative pain and chronic pain at 3-months and 6-months follow-up compared to the Surgipro. Throughout the whole follow-up of one year, we recorded a single recurrence for the PVDF mesh and three recurrences for the PP mesh.
Conclusion: Data from this study suggests that the use of large pore PVDF meshes is preferable compared to PP small pore meshes because it significantly decreases pain and chronic pain up to 6 months after surgery and acute foreign body sensation. After one year, there are still differences in pain but these are no more significant