Impact of posterior wall repair and mesh use on recurrence in inguinal hernia repair for adolescents and young adults

Objective

The study aimed to evaluate the efficacy of mesh use and posterior wall repair (PWR) during inguinal hernia repair in adolescents and young adults.

Methods

A total of 29,149 patients aged 12 to 30 who underwent inguinal hernia repair were selected from the Korean National Health Insurance claims data. Patients were divided into two groups: 12–18 years old and 19–30 years old. The recurrence rate and prevalence of chronic pain were compared depending on whether PWR was performed or mesh was used.

Results

The recurrence rates between high ligation and high ligation with PWR were not significantly different in both groups (2.3 % vs. 2.6 %; 2.6 % vs. 3.0 %; p = 0.285 and 0.168 for patients aged 12–18 and 19–30, respectively). The use of mesh was associated with a reduced recurrence rate in patients aged 19–30 (3.1 % vs. 1.9 % in no mesh vs. mesh use; p = 0.005); however, it was not significant in patients aged 12–18 (2.7 % vs. 2.1 % in no mesh vs. mesh use; p = 0.541). In multivariate analysis, nonuse of mesh was an independently significant factor associated with recurrence in patients aged 19–30, with an odds ratio of 0.62 (95 % confidence interval = 0.44–0.90; p = 0.01). Mesh use and PWR were not significant factor associated with chronic pain in all age groups.

Conclusion

The results of our study indicate that the use of mesh is associated with a lower recurrence rate in young adults (aged 19–30) undergoing inguinal hernia surgery. However, no such association was observed in adolescents (aged 12–18).