Post Operative Chronic Pain after Mesh Fixation by Absorbable and Non Absorbable Suture in Lichtenstein Meshplasty

Abstract

Introduction: Currently, Lichtenstein hernioplasty (tension-free mesh repair) is the gold standard surgical management for inguinal hernias with significantly low recurrence rate of <5%. However the reported incidence of chronic post-operative groin pain is 10-30% owing to tissue scarring, inflammatory reactions to the mesh, or irritation of inguinal nerves due to the mesh or sutures used for fixation. This study compares the effects of mesh fixation using absorbable versus non-absorbable sutures on post-surgery outcomes. Objective: To evaluate post-operative groin pain, recurrence rates, seroma formation, foreign body sensation, and surgical site infection in patients undergoing Lichtenstein meshplasty using either absorbable or non-absorbable sutures. Methods: A prospective, single-center, non-randomised, observational study was conducted at Government Medical College and Hospital, Chandigarh, involving 54 male patients with uncomplicated inguinal hernias. Two groups of 27 patients each underwent mesh fixation using either absorbable polyglactin or non-absorbable polypropylene sutures. Pain was assessed using the Visual Analogue Scale (VAS) and DN4 questionnaire, and patients were followed-up 3 months post-surgery. Results: There was no statistically significant difference in chronic pain at 3 months between the two groups (p=0.21). Other complications like seroma formation, foreign body sensation, and recurrence were also similar in both groups. No surgical site infections or hernia recurrences were observed during follow-up. Conclusion: Absorbable sutures offer a comparable alternative to non-absorbable sutures for mesh fixation in hernia repair, with similar outcomes in pain and complication rates. Further studies with larger sample sizes and longer follow-up are recommended to confirm these findings.