Polyglactine/Polypropylene Mesh vs. Propylene Mesh: Is there a need for newer prosthesis in inguinal hernia?

Abstract

Background/Aim:To compare outcomes of light and heavy weight mesh for repair of inguinal hernia.Materials and Methods:This study was conducted at the Department of Surgery; Lady Reading Hospital, Peshawar from January 1, 2007 to December 31, 2008. Patients were divided into two groups based on the type of mesh implanted for inguinal hernia repair. Group 1 included patients in whom light weight composite (VyproII®) mesh is implanted: Group 2 included patients in whom polypropylene (ProleneR) mesh is implanted. Data concerning the complications and post operative pain in the perioperative and postoperative period were collected and analyzed. Categorical data were presented as percentages with 95% confidence intervals and compared using a χ2test and P<0.05 were considered significant.Results:Following allocation and exclusion of violating cases, 111 patients in group 1 and 138 patients in group 2 were analyzed. The mean age in group 1 was 38.20 ± 13.34 years and in group 2 was 39.55 ± 13.70 (P = 0.434). In group 1, hematoma formation was observed in four cases (3.6%), while it was observed in six cases (4.2%) in group 2 (P = 0.766). During the entire study, ten patients in all developed urinary retention, three of which required transient catheterization. One year post operation, there was a recurrence in only five cases overall, while only two patients complained of pain (P = 0.826).Conclusion:The frequency of postoperative pain and complications in patients was similar in both groups.

Inguinal hernia repair-Challenges beyond zero recurrence

“…Hence a rethink on PPP is always welcome as attempted by Khan N et al . [ 6 ] The possible areas of improvement in PPP relate to size, shape, mass, fabric, design and architecture of the mesh. Tailoring the shape and size has not helped much.…”

“…[ 4 ] Meshes have even been considered a mechanical overkill. [ 4 ] It is with this background that an endeavor by Khan N et al .,[ 6 ] to study the PROs with reduced mass PPP needs notice. In this era of informed and increasingly litigious society[ 7 ] improving PROs is more than desirable.…”