Hernia| Volume 167, ISSUE 3, P609-613, March 2020

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Chronic pain and risk for reoperation for recurrence after inguinal hernia repair using self-gripping mesh

Published:December 12, 2019DOI:



      Improved recurrence rates after groin hernia surgery have led to chronic pain becoming the most troublesome postoperative complication. Self-gripping mesh was developed to decrease the risk for development of chronic pain. The aim of this nationwide cohort study was to compare recurrence rate and chronic pain 1 year after an open, anterior mesh repair of inguinal hernias with either a self-gripping mesh or other lightweight mesh.


      All operations registered as open anterior mesh repair (Lichtenstein) in the Swedish Hernia Registry between September 2012 and October 2016 were selected. At 1 year after repair, patients were sent a pain questionnaire assessing chronic pain. We compared the prevalence of chronic pain and reoperation for recurrence using lightweight, sutured mesh or self-gripping mesh.


      We analyzed the 1,803 repairs using self-gripping mesh and 16,567 repairs using lightweight mesh. We found no difference in the prevalence of chronic pain 1 year after the hernia repair between self-gripping mesh and sutured lightweight mesh (OR 0.92, CI 95% 0.80–1.06, P = .257). There was no increase in reoperation for recurrence when using self-gripping mesh (HR 0.71, CI 95% 0.45–1.14, P = .156). Mean operation time was considerably less when using self-gripping mesh (43 vs 70 minutes; P > .001).


      The use of self-gripping mesh does not decrease the incidence of chronic pain and reoperation for recurrence compared with lightweight, sutured mesh for open anterior mesh repair of inguinal hernias. Furthermore, the use of self-gripping mesh is associated with a clinically important, lesser operation time.
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      Linked Article

      • Re: Chronic pain and risk for reoperation for recurrence after inguinal hernia repair using self-gripping mesh
        SurgeryVol. 169Issue 5
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          We read with interest the report by Axman et al1 entitled “Chronic pain and risk for reoperation for recurrence after inguinal hernia using self-gripping mesh.” We found this subject relevant because chronic pain after inguinal hernia repair remains one of the main postoperative complications than can cause chronic distress to patients. The authors reported a rate of 15% of patients with chronic pain after inguinal hernia repair, and although in their methods section they reported to have recorded how the surgeon handled the nerves, these data were not published.
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