Chronic pain after open inguinal hernia surgery: suture fixation versus self-adhesive mesh repair

Chronic pain following inguinal hernia repair is a complex problem. Mesh fixation with sutures may be a contributing factor to this pain. The aim of this study was to compare the incidence of chronic pain and limitation of activities of daily living following inguinal hernia repair using a sutured mesh to a self-adhesive mesh, 6 months and 1 year following surgery.

All consecutive patients presenting to NHS Fife for open hernia repair between January 2009 and January 2010 were included in our analysis. A prospective survey of postoperative pain and activities of daily living was conducted at 6 months and 1 year following hernia repair. Chronic pain was assessed using the SF-36 questionnaire. The primary end points for analysis were incidence of chronic pain and limitation of activities of daily living.

Overall, 132 of 215 patients completed the questionnaire, 69 in the sutured group and 63 in the self-adhesive mesh group. The need for analgesics was similar during the first 24 h after surgery. Wound infections were detected in one patient in the Lichtenstein group and two in the second group. The incidence of chronic pain was 21 and 7.9% at 6 months and 18.8 and 6.3% at 1 year (p < 0.05). Moderate and vigorous activities were found to be limited some to all of the time in nine patients (60%) in the suture fixation group and in one patient in the self-adhesive group (20%, p < 0.02).

Open inguinal hernia repair with a self-adhesive mesh may lead to less chronic pain and less restriction of activities of daily living than a sutured mesh fixation.