In this study 300 patients were randomized to open repair with mesh and open repair without mesh. This is the gold standard method of performing a comparison study in surgery. After the surgery, the patients were followed for a median of over 10 years. The patients whose repair did not utilize mesh had a 17% recurrence rate (i.e. 17% failed over 10 years). Patients whose repair utilized mesh had a 1% recurrence rate. The authors also found “that mesh repair of inguinal hernia is equal to non-mesh repair with respect to long-term persistent pain and discomfort interfering with daily activity.” In other words, patients who had mesh did not have more pain or discomfort than patients who didn’t have mesh repair.
Scott N, Go PM, et al. Open Mesh versus non-Mesh for groin hernia repair. Cochrane Database of Systematic Reviews 2001, Issue 3.
This study is from Cochrane. It is a non-profit, non-government organization formed to organize medical research findings to facilitate evidence-based choices about health interventions faced by health professionals, patients, and policy makers. Cochrane includes 53 review groups that are based at research institutions worldwide.
This review by Cochrane examines the evidence from studies comparing different types of open surgery for people with groin hernia. They included only randomized studies comparing methods using synthetic mesh versus methods without mesh. There were 20 studies comparing mesh with non-mesh repair analyzed in this study.
Based on their analysis, there was strong evidence that fewer hernias recur after mesh repair than following non-mesh repair. There was a suggestion that people had less persisting pain after mesh repair, but results were only available for nine out of 20 trials. Open mesh methods were shorter to perform than Shouldice procedures (an open non-mesh repair) but took longer than other types of non-mesh repair. They found no clear differences between mesh and non-mesh methods for operative complications and persisting numbness. Overall, people spent less time in hospital and returned to their usual activities quicker after mesh repair.