Five-year results of inguinal hernia treatment with the Prolene Hernia System in a regional training hospital

PURPOSE: Long-term results of inguinal hernia repair with the Prolene Hernia System (PHS) in our regional training hospital were retrospectively analysed. Research was conducted in an identical cohort of patients previously investigated for short-term results.

METHODS: One-hundred and fifty-eight patients (217 inguinal hernias) treated with the PHS were traced and included. Patients were invited to visit the outpatient clinic for a brief history, physical examination and ultrasound. A quality of life questionnaire was completed by all patients. The primary endpoint was recurrence rate. Testis atrophy, chronic pain and hypaesthesia were secondary endpoints.

RESULTS: The mean age of the population (n = 187) was 62.2 years (range 28-92), with a male:female ratio of 15:1 (175:12). The median follow-up was 5.5 years (range 3.9-6.8). One-hundred and forty-five patients visited the outpatient clinic, while 13 patients were included by telephone interview. Twenty-one patients died during follow-up and eight others were lost to follow-up. The resulting follow-up rate was 85% (158/187). In our initial study, we found four recurrences (1.8%) and seven patients with persisting pain (3.2%) after 32 months. During current follow-up, five patients were diagnosed with recurrent herniation (2.3%, 5/217) and only four patients (1.8%) suffered from persisting pain. Three patients (1.4%) were diagnosed with testicular atrophy, while ten patients (4.4%) experienced hypaesthesia.

CONCLUSION: In a regional training hospital, the recurrence rate and long-term complications of patients treated for inguinal hernia with the PHS are acceptable after a follow-up of 5.5 years. The number of patients experiencing persistent pain seems to decrease over time.