SHORT-TERM OUTCOME AFTER MESH OR SHOULDICE HERNIORRHAPHY - A RANDOMIZED, PROSPECTIVE-STUDY

Background. Retrospective analyses have shown that long-term recurrenc e rates after Lichtenstein mesh and Shouldice herniorrhaphies are low. Therefore differences in short-term outcome may be important determin ants of one's choice of repair Although proponents of the mesh repair claim that their method is less morbid, to our knowledge no prospectiv e comparative studies of short-term morbidity have been reported Metho ds. One hundred five adult patients were randomized to undergo either a mesh or Shouldice inguinal hernia repair: Postoperative pain, narcot ic use, and time to resumption of usual activities and employment were recorded. Patients were blinded to the type of repair received until all data were collected. Results. There was no difference between the herniorrhaphy methods with respect to postoperative pain, duration of narcotic use, and time to resumption of usual activity and employment. Recovery was rapid for both groups of patients. By 3 days after opera tion 50 % of patients rated their pain as very mild or less and no lon ger required narcotic analgesics. Patients in both groups returned to usual activity and work by a median of 9 days after operation. Conclus ions. Both of these well-established methods can be wed to repair ingu inal hernias with local anesthetics in an outpatient setting with mini mal morbidity. Despite the ''tension-free'' design of the mesh repair short-term outcomes of mesh and Shouldice repairs of inguinal hernias do not differ.