Open tension-free hernioplasty: advantages and disadvantages 

N.G. Kulchenko RUDN University, Moscow 

Weak points in the anterior abdominal wall are prerequisites for hernias through a set of circumstances. Among anterior abdominal wall hernias, inguinal hernias are most common in men. Tension-free mesh repair is the "gold standard" for inguinal hernias. The mesh is used to strengthen the weakened wall of the inguinal canal. An important condition for the use of mesh is its secure fixation so that it remains in place and does not move during healing. Mesh implants have significantly improved the quality of surgical interventions. However, persistent groin pain and discomfort after tension-free hernioplasty significantly affect the quality of life and lead to disability. This paper reviews major postoperative complications after inguinal hernia repair using meshes of various chemical compositions. Typically, the main causes of chronic groin pain and sexual dysfunction are inguinal nerve damage (neuropathic cause) and compression of spermatic cord nerves with mesh (non-neuropathic cause). Current technologies with the use of meshes to strengthen the inguinal canal wall have significantly reduced the recurrence rate, but provoke chronic pain, sexual and reproductive dysfunction by causing a "foreign body sensation", on the other hand.

Keywords: inguinal hernia, hernia repair, tension-free hernioplasty, mesh repair, operation time, polypropylene mesh, self-fixing mesh, sexual dysfunctions, male infertility, chronic pain.

For citation: Kulchenko N.G. Open tension-free hernioplasty: advantages and disadvantages. RMJ. 2023;8:15–19.