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Effects of Mesh Use on Chronic Pain Following Inguinal Herniorrhaphy

대한탈장학회지 2019년 9권 2호 p.23 ~ 30
조재림, 윤호근,
소속 상세정보
조재림 ( Cho Jae-lim ) - University of Auckland School of Medicine
윤호근 ( Youn Ho-Geun ) - VHS Medical Center Department of Surgery

Abstract


Purpose: This study aimed to evaluate the effect of mesh use on chronic pain after inguinal herniorrhaphy.

Methods: Twenty four patients from VHS Medical Center who presented with bilateral inguinal hernia and were using modified Kugel patches between August 2016 and July 2018 were enrolled in the study. This study was designed to compare the pain on both sides using only an optional open onlay mesh on one side.

Results: All patients experienced pain and discomfort on one side prior to herniorrhaphy, which we defined as the main lesion. All patients were male, with a median age of 71 years. An onlay mesh was used for the main lesion in half of the patients and for the opposite lesion in the rest of the patients. Most patients exhibited symptoms on the left inguinal side, and direct hernia was predominant. During the follow-up period, recurrence of hernia was not evident. The differences in pain scores between both sides (+onlay vs ?onlay mesh use) were not statistically significant for pain at rest (P=0.702) or pain during activity (P=0.905).

Conclusion: Although inflammation and fibrosis may develop due to mesh use, the mesh did not cause additional pain after inguinal herniorrhaphy. Chronic pain may not develop if inguinal herniorrhaphy with mesh is performed with careful dissection and adequate fixation of the mesh.

키워드

Inguinal herniorrhaphy; Onlay mesh; Main lesion; Hernia; Chronic pain

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