Incidence of chronic pain after single stitch mesh fixation in open inguinal hernia repair: An observational prospective study, a case series

Abstract Background Chronic pain, after Lichtenstein inguinal hernia repair, remains a frequent complication. Various causes for post operative pain from Liechtenstein inguinal repair have been suggested, one of them being the use of sutures for fixing the mesh to the inguinal ligament. The present study was undertaken to evaluate the incidence of chronic pain and recurrence rate, using a single stitch mesh fixation in open inguinal hernia repair. Methods 625 male patients between 18 and 60 years operated for open inguinal hernia repair. The incidence of pain at one week, one month, three months and one year were recorded. The effect of physical activity and recurrence rates were also recorded. A 3-0,polypropylene suture was used to secure the lower medial corner of the mesh to the soft tissue overlying the pubic tubercle. Results Majority of the patients fall between the age group of 40 and 60 (80%) years and all are male patients. Of the total cases, 313 were right sided, 200 were left sided, and 112 were bilateral. 82 patients required further analgesics for one more week, 10 patients required analgesics for another two weeks while only one patient had analgesics for one more post-operative month. All patients were performing all their activities after 15 days. There was one recurrence at the end of three months. Conclusions Single stitch mesh fixation over pubic tubercle in open inguinal hernia repair causes minimum postoperative chronic pain with 0.2% recurrence.