[Management of inguinal hernia--a comparison of current methods]

Between July 1995 and June 1996, 280 patients were operated on for inguinal hernia within the scope of a prospective, randomized study. The aim of the study was to compare the Shouldice technique with tension-free hernioplasty (Lichtenstein, TAPP). The operation time was comparable in all three groups. There was less need for analgesics and postoperative morbidity was less after the tension-free technique. No severe complications such as deep wound infection or infection of the implant were seen in any of the groups. After a follow-up period of 18 months, we found two recurrences after the Shouldice operation and one recurrence in each of the tension-free groups. Treatment satisfaction after tension-free hernioplasty was high. One year after the Shouldice operation, about 10% of the patients were dissatisfied because of persistent discomfort and pain. Because of lower morbidity, less pain, and low recurrence rates after tension-free hernioplasty, we find the tension-free techniques to be superior to conventional hernioplasty.