[My experience in repairing, without tension, primary inguinal hernia in men]

Beginning in 1990, the tension-free inguinal hernioplasties were adopted for the treatment of primary groin hernias in men. 1252 tension-free hernioplasties were performed in 1,076 men and followed for one to six years. Lichenstein's tension-free hernioplasty and Gilbert's sutureless hernioplasty were used, usually in combination. Anesthesia was local in 97% of the operations. 15 complications occurred (1.2%): one wound infection, one seroma, 12 hematomas, and one ilioinguinal neuralgia, 6 recurrences occurred (0.5%): 4 indirect, one direct and one femoral. No indirect recurrences have occurred since placing Gilbert's cone shaped plug in the deep ring. Tension-free hernioplasties consisting of a patch of polypropylene mesh plus a cone plug of the same material, placed in the deep ring when an indirect hernia is present, produce excellent results and are the preferred methods to manage the majority of primary inguinal hernias in men.