Postoperative pain and pain-related health-care contacts after open inguinal hernia repair with Adhesix™ and Progrip™: a randomized controlled trial.

Abstract

<h4>Purpose</h4>Self-fixed mesh is an alternative to suture mesh fixation in inguinal hernia repair. The aim of this study was to evaluate postoperative pain after open inguinal hernia surgery using self-fixed meshes.<h4>Methods</h4>A randomized clinical trial comparing self-adhesive mesh (Adhesix™) and self-gripping mesh (Progrip™) was conducted from November 2018 through March 2021. Patients included were male, 18-85 years old, and suitable for day case surgery. The primary endpoint was the number of patients needing follow-up visits due to postoperative pain during the first 3 postoperative months. Secondary endpoints included the intensity of pain, the time of return to work and normal daily activities, quality of life measures and postoperative complications.<h4>Results</h4>270 patients were enrolled, 132 received Adhesix™ mesh (A group) and 138 Progrip™ mesh (P group), 231 (85.6%) completed 1- or 3-month follow-up. The number of patients needing follow-up for postoperative pain was significantly higher in the P group (19 vs. 4, p = 0.001). The P group had higher numeric rating scale of pain while coughing (P 0.50 vs. A 0.20, p = 0.024) and during exercise (P 1.02 vs. A 0.60, p = 0.057) at 3 months postoperatively. The time of return to normal activity was 16.6 days in the A group and 22.9 days in the P group, (p = 0.004). The postoperative day being fit for work was sooner for the A group (14.3 days vs 17.8 days, p = 0.009).<h4>Conclusion</h4>This study demonstrated an advantage of self-adhesive mesh over self-gripping mesh with respect to acute postoperative pain and thus faster recovery after surgery.