Computed tomographic appearance of prolene hernia system and polypropylene mesh plug inguinal hernia repair

Purpose: To describe the normal postoperative computed tomographic (CT) appearance of inguinal hernia repair with the Prolene (polypropylene) Hernia System and polypropylene mesh plug. Materials and Methods: The medical records for 480 consecutive patients who underwent inguinal mesh hernioplasty were reviewed to identify posthernioplasty pelvic CT scans. The presence or absence of the appearance and size of focal inguinal findings at CT for each groin was recorded by 2 radiologists in consensus. The CT scan reports and medical records were reviewed to determine prospective interpretations of these inguinal findings. Findings: Posthernoplasty CT scans were identified in 26 patients, of whom, 20 had Prolene Hernia System (unilateral, n = 20; bilateral, n = 1) or mesh plug (unilateral, n = 5; bilateral, n = 1) repairs. These patients consisted of 23 men and 3 women with a mean age of 63 years (range, 36-89 years). For Prolene Hernia System hernioplasty patients, ipsilateral focal inguinal findings were found at CT in 21 of 22 groins. These focal findings had a mean size of 2.6 ± 0.4 by 2.0 ± 0.5 cm and were ringlike in 9, nodular in 7, and feathery in appearance in 5 groins. For mesh-plug hernioplasty, ipsilateral nodular focal inguinal findings were found in all 6 of 6 groins at CT. In 2 patients, nodular focal inguinal findings were mistaken for lymphadenopathy on the prospective CT report. Conclusion: Focal inguinal findings from mesh plug inguinal hernioplasty are common, have characteristic appearances at CT, and should not be mistaken as lymphadenopathy.