Long-term discomfort after plug and patch hernioplasty

Abstract

collected 5 years after hernioplasty by an expert in locating people. Of 839 patients, 764 (91%) were contacted by a physician and answered a telephone questionnaire. Only 75 patients were lost at follow-up because of change of address. Among the more important questions were: Do you feel any painful sensation? Do you feel anything abnormal in the groin? Do you have any recurrence or any other symptom? All patients (119 of 764) complaining of any sign consistent with discomfort or painful sensation throughout the groin attended a physical examination by an independent surgeon, with experience in hernia surgery. As in the study of Berndsen, the importance of pain was graduated as mild (occasional discomfort or pain that does not interfere with daily activity), moderate (discomfort or pain that occasionally interferes with daily activity) and severe (discomfort or pain that interferes with daily activity). Results are shown in Table 1. At physical examination, 19 of 24 patients turned from moderate to mild. Overall discomfort after 5 years was 6.5%, with only 0.9% of patients complaining of moderate (0.6%) or severe (0.3%) pain. We found no relationship between late discomfort and early postoperative pain. On the contrary, a correlation with preoperative pain was evidenced, but it was not statistically signiWcant. Our results from this large series, with high follow-up percentage (91%) and supplemental physical examination after 5 years, have demonstrated that the incidence of late discomfort after plug and patch hernioplasty is as low as it is for the TAPP procedure in Berndsen’s study. Our present purpose is not to compare late results of plug and patch repair with that technique but to stress that the true incidence of long-term discomfort after prosthetic hernioplasty could not be as high for all well-standardised techniques as believed.