ﺑﺎﺯﮔﺸﺖ ﺑﻪ ﺻﻔﺤﻪ ﻗﺒﻠﯽ
خرید پکیج
تعداد آیتم قابل مشاهده باقیمانده : 3 مورد
نسخه الکترونیک
medimedia.ir

Complications of inguinal and femoral hernia repair

Complications of inguinal and femoral hernia repair
Literature review current through: Jan 2024.
This topic last updated: Aug 16, 2022.

INTRODUCTION — Complications after inguinal or femoral hernia repair are relatively common. Complications that occur in the perioperative period include wound seroma/hematoma, urinary retention, and superficial incisional surgical site infection, while complications that occur later following hernia repair include persistent groin pain, sexual dysfunction, deep incisional/mesh infection, recurrent hernia, and mesh migration and erosion. These complications will be reviewed here.

The operative techniques for inguinal and femoral hernia repair, including methods to prevent complications related to repair, are reviewed elsewhere. (See "Open surgical repair of inguinal and femoral hernia in adults" and "Laparoscopic inguinal and femoral hernia repair in adults" and "Robotic groin hernia repair".)

INCIDENCE — The overall complication rate after inguinal hernia repair is 3 to 8 percent [1], with specific incidences depending upon the clinical circumstance under which the repair was performed as well as the site and type of the hernia [2,3].

Urgent and emergency procedures are associated with higher complication rates compared with elective repair [4,5]. In one review of 1034 groin hernia repairs, overall complication rates were 27 percent for urgent or emergency hernia repairs and 15.1 percent for elective repairs [5]. Higher complication rates are also seen with repair of recurrent hernia compared with primary hernia repair. In studies comparing open and laparoscopic repair, the overall incidence of complications is similar; however, the nature of the complications differs.

In a review that included 6895 groin hernia repairs in women and 83,753 in men, although the overall incidence of postoperative complications was similar, the need to resect bowel was higher in women compared with men (16.6 versus 5.6 percent), likely related to the greater proportion of women who required emergency hernia repair [4]. However, under elective circumstances, women had a slightly lower rate of postoperative complications (7.0 versus 8.5 percent).

SURGICAL SITE OCCURRENCES — Surgical site occurrence (SSO) is a term used by the Ventral Hernia Working Group to describe not only surgical site infections (SSIs) but also other wound-related events such as wound cellulitis, nonhealing incisional wound, fascial disruption, skin or soft tissue ischemia, skin or soft tissue necrosis, wound serous or purulent drainage, stitch abscess, seroma, hematoma, and infected or exposed mesh in addition to SSI, wound dehiscence, and enterocutaneous fistula [6-8].

In a 2019 review of 4613 groin hernia repairs from the Americas Hernia Society Quality Collaborative (AHSQC) database, SSO was reported in 30 percent of open repairs (mostly Lichtenstein), 80 percent of which were seromas and hematomas. SSI was reported in 1 percent of open repairs, almost all of which were superficial [3]. In the same study, SSO was reported in 10 percent of minimally invasive repairs, almost all of which were seromas and hematomas. SSI was reported in 1 percent of minimally invasive repairs as well, almost all of which were again superficial [3].

Seroma/hematoma — Bruising, seroma, and hematoma formation are relatively common following inguinal and femoral hernia repair. Seromas and hematomas are due to the collection of fluid or blood in the dead space that remains once a hernia sac has been reduced. They can present as significant scrotal swelling (if the original hernia involved the scrotum) or inguinal swelling (if the original hernia did not involve the scrotum).

In the surgery versus watchful waiting trial, 6.1 percent of patients undergoing open mesh repair developed a wound hematoma, 4.5 percent developed a scrotal hematoma, and 1.6 percent developed a seroma [9]. Seromas and hematomas were reported in approximately 5 percent of laparoscopic hernia repairs [10]. Most patients included in this trial were older men with asymptomatic or minimally symptomatic inguinal hernias.

One meta-analysis found a lower incidence of hematoma formation after laparoscopic versus open groin hernia repair with the difference attributed to a lower incidence of hematoma after totally extraperitoneal (TEP) but not transabdominal preperitoneal (TAPP) repair [11]. There was no difference in the incidence of hematoma formation between various open repair techniques [12-14].

Several meta-analyses reported a higher incidence of seroma formation after laparoscopic (TEP or TAPP) repair than open repair [11,15,16], whereas there is no difference in the incidence of seromas after various open repairs [14,17]. When repairing large direct hernias laparoscopically, inverting the transversalis fascia and closing the defect may reduce the incidence of seroma formation [18,19].

There is no conclusive evidence that routine drain placement will reduce the incidence of seroma/hematoma formation after groin hernia repair [16,20], and neither is there any evidence that abdominal binders or other compression devices reduce seroma/hematoma formation.

Seroma or hematoma may be mistaken as (ie, pseudohernia), and must be differentiated from, a hernia recurrence since the typical clinical presentation is similar (ie, groin mass and pain). Ultrasonography or cross-sectional imaging, for example computed tomography (CT), can help distinguish hernia recurrence from a seroma or hematoma. (See 'Recurrent hernia' below.)

Most fluid collections resolve without specific treatment. Fluid collections should not be aspirated in the absence of accompanying clinical features of infection, as this poses a risk for introducing infection into a sterile site [21]. Hematomas may spontaneously decompress through the wound, which can be unsettling to the patient but is generally not serious.

Surgical site infection — The standardized definition of an SSI developed by the Centers for Disease Control and Prevention (CDC) is an infection that occurs in the part of the body where the surgery took place and includes superficial, deep, and organ space infections, and this has become universally accepted (table 1). (See "Overview of the evaluation and management of surgical site infection", section on 'Definition'.)

Superficial incisional surgical site infection — The rate of superficial incisional SSI (table 1) following elective inguinal and femoral hernia repair is overall low. A systematic review of open inguinal hernia repair found rates of infection between 3 and 5 percent [22]. Patients undergoing mesh repair are at a slightly higher risk of developing an infection [23]. The risk of infection may be higher when mesh is used to repair large defects and/or in the setting of comorbid conditions such as diabetes, immunosuppression, or obesity. (See "Wound infection following repair of abdominal wall hernia", section on 'Epidemiology and risk factors'.)

Patients with superficial incisional SSI should be initiated on antibiotic therapy. If available, culture findings should guide choice of therapy; otherwise, empiric broad-spectrum parenteral antibiotics should be administered (table 2). Most patients who develop a superficial incisional SSI can be successfully treated with antibiotics without the need to remove the prosthetic material [24]. Symptoms of infection should improve after a few days of antibiotic treatment. Antibiotics should be continued for 10 to 14 days or until the clinical signs of active infection have resolved. Thereafter, the patient should be monitored closely for signs of recurrent infection. Oral antibiotics may be used to complete therapy in patients who improve quickly and can tolerate oral therapy.

If signs of superficial incisional SSI do not improve with antibiotic therapy, a deep incisional infection may be present, and surgical incision and drainage with debridement of infected and/or necrotic tissue may be necessary. (See 'Deep incisional/mesh infection' below.)

Deep incisional/mesh infection — Deep incisional SSIs or mesh graft infections (table 1) can present within the first few weeks after surgery or later (months to years after surgery) [25]. The incidence of deep incisional SSI following inguinal hernia repair is similar for open and laparoscopic hernia repair, at between 0.1 and 0.2 percent [26]. Risk factors include smoking, obesity, diabetes, glucocorticoid use, and prior hernia surgery [27]. (See "Wound infection following repair of abdominal wall hernia", section on 'Epidemiology and risk factors'.)

A deep wound/mesh infection should be suspected in any patient with a history of groin hernia repair who presents with fevers, chills, or malaise. Findings on physical examination may include pain, erythema, warmth, swelling, and/or a draining fistula in the groin region. (See "Wound infection following repair of abdominal wall hernia", section on 'Clinical features and diagnosis'.)

The diagnosis of deep incisional SSI/mesh infection is usually clinical, but imaging modalities such as ultrasound or CT can be useful for identifying fluid collections (seroma, hematoma, abscess), edema or stranding of the subcutaneous fat around the mesh, or other signs of tissue ischemia/necrosis. Patients with clinical manifestations of infection and associated fluid collections should undergo either percutaneous or open drainage, depending on the extent of infection [21].

Bacteria typically implicated in mesh implant infections are those with the capacity to form biofilm, such as coagulase-negative staphylococci and Staphylococcus aureus [28-30]. Enteric gram-negative bacteria and anaerobes are also potential pathogens [31]. Rarely, mesh infections can be caused by Candida or mycobacteria [32,33].

The optimal management of infected mesh graft is not well defined [34]. Patients with suspected mesh infection should initially be started on empiric broad-spectrum parenteral antibiotics with the results of subsequent fluid or tissue culture (aerobic and anaerobic) and sensitivities guiding subsequent choice of therapy (table 2).

Patients without systemic signs who have localized fluid collections can undergo an attempt at percutaneous drainage. In a retrospective study that evaluated outcomes in 21 patients who underwent percutaneous drainage for mesh-related fluid collections, 12 patients (57 percent) were successfully treated with percutaneous drainage and antibiotics [35]. In this study, fluid cultures were positive in 68 percent of patients (n = 13); S. aureus was the most common organism. However, the pathogen did not predict the need for mesh excision. If symptoms persist following debridement/drainage and one week of appropriate antibiotic therapy, all foreign material, including mesh, sutures, and staples (as well as necrotic tissue), should be removed when technically feasible [36,37].

Patients who present with systemic symptoms and signs of sepsis and local evidence of a severe infection should undergo immediate surgical debridement of any infected and/or necrotic tissue as well as mesh removal if feasible. Debrided material should be sent for culture and sensitivities and the results used to tailor choice of antibiotic therapy. (See "Necrotizing soft tissue infections".)

Following removal of the mesh or other foreign material, antibiotics should be administered for at least two weeks. If symptoms of infection recur following removal of foreign material, incomplete removal with retention of mesh components should be suspected, and repeat debridement should be undertaken. (See "Wound infection following repair of abdominal wall hernia", section on 'Deep incisional surgical site/mesh infection'.)

Although mesh removal can lead to hernia recurrence [38], the infection should be fully eradicated before recurrent hernia repair is performed. Some surgeons favor percutaneous sampling of the operative area under sterile conditions to ensure there are no residual bacteria prior to repeat hernia repair [39]. If such cultures are positive, an additional two weeks of antibiotics should be administered, followed by repeat aspiration. Patients with persistently positive aspirates should undergo repeat debridement followed by additional antibiotic therapy. When needed, methods are available to repair groin hernia without the use of mesh and are discussed elsewhere. (See "Open surgical repair of inguinal and femoral hernia in adults", section on 'Nonmesh repairs'.)

Mesh migration and erosion — Following inguinal and femoral hernia repair, erosion of mesh into adjacent structures can occur, and depending upon the symptoms and nature of the structures involved, treatment may require mesh removal.

Mesh migration can be classified as primary or secondary [40]. Primary mechanical migration is displacement of the mesh along paths of least resistance due to inadequate fixation or external forces. Secondary migration is the slow and gradual movement of mesh through adjacent anatomic structures as a consequence of a chronic foreign body reaction. As a result of one of these mechanisms, erosion of mesh into the bladder leading to recurrent urinary tract infection or hematuria, erosion into the spermatic cord causing vasal obstruction, and erosion into or exposure to the abdominal cavity causing fistula formation or bowel obstruction have all been reported [40-42].

GENITOURINARY COMPLICATIONS

Urinary retention — The incidence of urinary retention following groin hernia repair varies from 1 to 20 percent [2,43,44]. The type of anesthesia used is the best predictor, with 0.37, 2.42, and 3 percent of patients developing urinary retention after groin hernia repair under local, regional, and general anesthesia, respectively [45]. Other risk factors of urinary retention include overhydration with intravenous fluid, bilateral hernias, increased body mass index, opioid analgesics, older age, prostatic symptoms, and longer operative time [46-48].

Laparoscopic groin hernia repair is associated with a higher incidence of urinary retention, presumably because it requires general anesthesia. When both performed under general anesthesia, open and laparoscopic repair have similar rates of urinary retention. Other than that, meta-analyses of randomized trials comparing various hernia techniques have not shown a difference in urinary retention rates among the various laparoscopic and open techniques [45,49].

Prophylactic urinary catheterization is not necessary before either open or laparoscopic groin hernia repair [50]. Instead, the patient should be asked to empty the bladder just prior to surgery. Some surgeons give an alpha-1-receptor antagonist preoperatively (eg, tamsulosin) to prevent postoperative urinary retention. In a meta-analysis of five trials, preoperative alpha blockade reduced the incidence of urinary retention requiring catheterization by 20 percent [51,52].

Post-herniorrhaphy urinary retention can be treated with intermittent catheterization or temporary indwelling catheter placement. The management of urinary retention is discussed separately. (See "Acute urinary retention", section on 'Bladder decompression'.)

Sexual dysfunction or sexual pain — Pain at sexual activity induced by a groin hernia occurs between 25 and 30 percent preoperatively and persists between 10 and 15 percent postoperatively [53]. Groin hernia surgery can negatively impact the sexual health of the patient in several ways:

Nerve injury can cause chronic pain, which in turn can interfere with sexual activities. (See 'Persistent groin pain and post-herniorrhaphy neuralgia' below.)

Interruption of blood supply to the testicle, typically resulting from the dissection of an indirect hernia from the cord structures (open or laparoscopic), can lead to testicular pain, ischemic orchitis, and testicular atrophy [54,55]. The incidence of testicular complications ranges from 0.3 to 7.2 percent [10].

Complications may also result from direct injury, extrinsic compression of cord structures, or a fibrotic reaction to polypropylene mesh. Transection or obstruction of the vas deferens, which can lead to ejaculatory problems, is of particular concern in young men [56].

In a systematic review and meta-analysis of 12 studies with a median follow-up of 10.5 months, open inguinal hernia repair was associated with sexual dysfunction and persistent sexual pain in 3.7 (95% CI 2.0-6.8) and 12.5 (95% CI 6.4-23.3) percent of patients, respectively [57]. Minimally invasive inguinal hernia repair was associated with sexual dysfunction and persistent sexual pain in 7.8 (95% CI 5.4-11.3) and 7.4 (95% CI 4.7-11.5) percent of patients, respectively.

Published after the meta-analysis, a trial of 176 men undergoing unilateral inguinal hernia repair reported that totally extraperitoneal (TEP) repair resulted in higher quality of life and sexual function scores than open (Lichtenstein) repair at 7 and 30 days but not 90 days [58].

Treatment of chronic groin pain may benefit the patient's sexual health as well [59]. This is discussed in detail elsewhere. (See "Post-herniorrhaphy groin pain".)

Infertility — Male infertility can be caused by operative injury to the vas deferens during bilateral groin hernia repairs [60], vas obstruction caused by severe mesh-related inflammation [56], or antibody-mediated immune response to spilled sperm [61,62].

Although bilateral mesh repair is associated with a higher incidence of infertility compared with suture repair [63], the risk is low, and there is no increased risk of infertility in men who undergo bilateral groin hernia repair compared with the general population [64].

Infertility caused by interruption to the vas deferens can be reversed surgically by vasovasostomy anastomosis. However, this technique usually works on children [65]; only a minority of adults who suffer mesh-related vas occlusion will benefit [56].

RARE BUT SERIOUS COMPLICATIONS

Injury to intra-abdominal organs — Potentially serious complications, defined as bowel, vascular, or bladder injury, are rare and occur in 0.1 to 1.4 percent of groin hernia repairs [15,43,66]. Some studies found that such injuries are more common in laparoscopic than in open repair [11,43] and more common in transabdominal preperitoneal (TAPP) than in totally extraperitoneal (TEP) repairs as the peritoneum is routinely entered for TAPP but not TEP or open repairs [67]. Prior lower abdominal surgery is associated with an increased risk of serious complications in laparoscopic repairs [68].

Vascular injury – During laparoscopic access, vascular injury, most commonly of the epigastric artery or vein or external iliac artery or vein, can cause bleeding resulting in hematoma formation. (See "Complications of laparoscopic surgery", section on 'Vascular injuries'.)

During TEP repair, vascular injuries can also occur in the preperitoneal space, which typically involve the epigastric vessels or the aberrant obturator vessels crossing the Cooper ligament (ie, corona mortis) [69].

Bladder injury – Bladder injury is a rare complication during open hernia repair and occurs in fewer than 1 percent of patients undergoing laparoscopic inguinal hernia repair [70,71]. The bladder can be damaged during trocar insertion during initial abdominal access or during the development of the peritoneal flap. (See "Complications of laparoscopic surgery".)

Bladder injury can also be the result of mesh migration. (See 'Mesh migration and erosion' above.)

Cardiovascular events — Despite the fact that many groin herniorrhaphies can be performed under local anesthesia with sedation, there can be serious cardiovascular complications. In an administrative database study of over 140,000 groin hernia surgeries, major cardiovascular complications occurred in 0.4 percent of patients within 30 days, including myocardial infarction (0.1 percent), stroke (0.3 percent), and pulmonary emboli (0.05 percent) [72]. In another study, cardiovascular disease caused 59 percent of the observed mortality in elective cases [73].

The high volume of groin hernia surgery renders these complications important, even when the percentage risks are relatively low. Risk factors for cardiovascular complications include emergency operation, age over 60 years, and American Society of Anesthesiologists (ASA) class III or above.

Mortality — Death resulting from groin hernia repair is very rare (0.12 to 0.5 percent [74-76]). However, the mortality rate is higher with emergency repair (4 to 5.8 percent [74,75]), with femoral hernia repair (3.1 percent [77]), and in older patients (8.7 percent increase in surgical mortality for every one-year increase in age [78]).

In a meta-analysis, factors associated with increased morbidity and mortality included age >49 years, delayed presentation to hospital, presence of a femoral hernia, nonviable bowel, and ASA class above 2 [74].

PERSISTENT GROIN PAIN AND POST-HERNIORRHAPHY NEURALGIA — Persistent pain following groin hernia surgery is common. Some form of chronic or residual postoperative discomfort/pain is present after inguinal or femoral hernia repair with reported rates ranging from 0.7 to 43.3 percent [79,80]. The nature of the pain can vary over time. Pain following hernia surgery should subside within an expected time interval, but when pain persists for more than three months and is shown not to be related to other causes, a presumptive diagnosis of post-herniorrhaphy neuralgia can be made. The clinical features, diagnosis, and treatment of post-herniorrhaphy neuralgia are discussed elsewhere. (See "Post-herniorrhaphy groin pain".)

RECURRENT HERNIA — Recurrent hernia occurs in 0.5 to 15 percent of patients depending upon the type of hernia repair initially performed, the comorbidities of the patient, and the duration of time from the original hernia repair. Lower rates of hernia recurrence are mostly correlated with tension-free hernia repair (open or laparoscopic), which is usually accomplished with an intervening layer of mesh (except Shouldice repair). Primary closure of the involved tissues (no mesh) leads to hernia recurrence in up to 15 percent of patients, compared with approximately a 1 to 2 percent recurrence rate for tension-free mesh repair. Recurrence rates for specific repairs and techniques for the repair of recurrent hernia are discussed elsewhere. (See "Open surgical repair of inguinal and femoral hernia in adults", section on 'Outcomes' and "Laparoscopic inguinal and femoral hernia repair in adults", section on 'Complications' and "Recurrent inguinal and femoral hernia".)

In a retrospective study of 138 patients who underwent primary femoral hernia repairs, 25 (18 percent) experienced recurrence at five years [81]. There was no difference in recurrence rate or time to recurrence according to repair type (suture only, suture and mesh, or mesh only) or surgical approach (various open techniques and laparoscopic preperitoneal repair).

SOCIETY GUIDELINE LINKS — Links to society and government-sponsored guidelines from selected countries and regions around the world are provided separately. (See "Society guideline links: Groin hernia in adults".)

INFORMATION FOR PATIENTS — UpToDate offers two types of patient education materials, "The Basics" and "Beyond the Basics." The Basics patient education pieces are written in plain language, at the 5th to 6th grade reading level, and they answer the four or five key questions a patient might have about a given condition. These articles are best for patients who want a general overview and who prefer short, easy-to-read materials. Beyond the Basics patient education pieces are longer, more sophisticated, and more detailed. These articles are written at the 10th to 12th grade reading level and are best for patients who want in-depth information and are comfortable with some medical jargon.

Here are the patient education articles that are relevant to this topic. We encourage you to print or e-mail these topics to your patients. (You can also locate patient education articles on a variety of subjects by searching on "patient info" and the keyword(s) of interest.)

Basics topics (see "Patient education: Seroma (The Basics)")

SUMMARY AND RECOMMENDATIONS

Incidence – The overall complications after inguinal hernia repair is 3 to 8 percent; the specific incidence is increased for emergency hernia repair and recurrent hernia repair and may be higher in men compared with women for elective repairs. (See 'Incidence' above.)

Surgical site occurrence complications – These include all wound-related complications. (See 'Surgical site occurrences' above.)

Seroma/hematoma – Bruising, seroma, and hematoma formation are relatively common following inguinal and femoral hernia repair. Most fluid collections resolve without specific treatment. Thus, they should not be aspirated in the absence of accompanying clinical features of infection. (See 'Seroma/hematoma' above.)

Surgical site infections – The incidence of infection (superficial or deep incisional) following elective inguinal and femoral hernia repair is overall low. The diagnosis is usually clinical, but imaging modalities such as ultrasound or CT can be useful to identify fluid collections (seroma, hematoma, abscess) or other signs of infection, tissue ischemia, and necrosis. (See 'Superficial incisional surgical site infection' above.)

Superficial wound infections can usually be treated with antibiotic therapy (table 2). Deep incisional or mesh infections may require either percutaneous or open drainage or surgical debridement of any infected and/or necrotic tissue, and/or mesh removal. (See 'Deep incisional/mesh infection' above.)

Mesh complications – Mesh graft infection can present early (within the first few weeks after surgery) or late (months to years after surgery). Additionally, mesh can erode into adjacent organs (eg, bladder, bowel). (See 'Mesh migration and erosion' above.)

Genitourinary complications – Genitourinary complications of inguinal and femoral hernia repair include postoperative urinary retention, sexual dysfunction, and infertility.

The risk of urinary retention is generally higher with laparoscopic repair because of the need for general anesthesia. Preemptive bladder catheterization is not necessary for either open or laparoscopic repair. Preoperative alpha blockers (eg, tamsulosin) have shown a reduction in urinary retention requiring intervention. (See 'Urinary retention' above.)

The patient's sexual health can be negatively impacted by groin hernia repair due to nerve injury causing chronic pain, injury to the structures supplying the testes leading to testicular pain, ischemic orchitis, and direct injury to the vas deferens. (See 'Sexual dysfunction or sexual pain' above.)

Male infertility can be caused by bilateral injury to the vas deferens, mesh-related inflammation, or antibody-mediated immune reaction to spilled sperm. (See 'Infertility' above.)

Intra-abdominal organ injury – Potentially serious complications, defined as bowel, vascular, or bladder injury, are rare. Some studies found that such injuries are more common in laparoscopic than in open repair and more common in transabdominal preperitoneal (TAPP) than in totally extraperitoneal (TEP) repairs. Prior lower abdominal surgery is associated with an increased risk of serious complications in laparoscopic repairs. (See 'Injury to intra-abdominal organs' above.)

Mortality or cardiovascular events – Death resulting from a groin hernia repair is very rare in the elective setting but is more common with emergency repair, femoral hernia repair, and in older patients. Cardiovascular events contribute toward a significant proportion of mortality. (See 'Cardiovascular events' above and 'Mortality' above.)

Persistent pain – Persistent pain following groin hernia surgery has become the predominant complication following groin hernia repair, with some form of residual postoperative discomfort/pain present in up to 40 percent of patients. When pain persists for more than three months after groin hernia repair and is shown not to be related to other causes, a presumptive diagnosis of post-herniorrhaphy neuralgia can be made. (See "Post-herniorrhaphy groin pain".)

Recurrent hernia – The incidence of recurrent hernia depends upon the type of hernia repair initially performed, the comorbidities of the patient, and the duration of time from the original hernia repair. Hernia recurrence may also result from the need to remove mesh to treat mesh infection or due to erosion of mesh into adjacent structures. (See "Recurrent inguinal and femoral hernia".)

  1. Weyhe D, Tabriz N, Sahlmann B, Uslar VN. Risk factors for perioperative complications in inguinal hernia repair - a systematic review. Innov Surg Sci 2017; 2:47.
  2. Matthews RD, Anthony T, Kim LT, et al. Factors associated with postoperative complications and hernia recurrence for patients undergoing inguinal hernia repair: a report from the VA Cooperative Hernia Study Group. Am J Surg 2007; 194:611.
  3. AlMarzooqi R, Tish S, Huang LC, et al. Review of inguinal hernia repair techniques within the Americas Hernia Society Quality Collaborative. Hernia 2019; 23:429.
  4. Koch A, Edwards A, Haapaniemi S, et al. Prospective evaluation of 6895 groin hernia repairs in women. Br J Surg 2005; 92:1553.
  5. Abi-Haidar Y, Sanchez V, Itani KM. Risk factors and outcomes of acute versus elective groin hernia surgery. J Am Coll Surg 2011; 213:363.
  6. Ventral Hernia Working Group, Breuing K, Butler CE, et al. Incisional ventral hernias: review of the literature and recommendations regarding the grading and technique of repair. Surgery 2010; 148:544.
  7. DeBord J, Novitsky Y, Fitzgibbons R, et al. SSI, SSO, SSE, SSOPI: the elusive language of complications in hernia surgery. Hernia 2018; 22:737.
  8. Haskins IN, Horne CM, Krpata DM, et al. A call for standardization of wound events reporting following ventral hernia repair. Hernia 2018; 22:729.
  9. Fitzgibbons RJ Jr, Giobbie-Hurder A, Gibbs JO, et al. Watchful waiting vs repair of inguinal hernia in minimally symptomatic men: a randomized clinical trial. JAMA 2006; 295:285.
  10. Hawn MT, Itani KM, Giobbie-Hurder A, et al. Patient-reported outcomes after inguinal herniorrhaphy. Surgery 2006; 140:198.
  11. McCormack K, Scott NW, Go PM, et al. Laparoscopic techniques versus open techniques for inguinal hernia repair. Cochrane Database Syst Rev 2003; :CD001785.
  12. Li J, Ji Z, Cheng T. Comparison of open preperitoneal and Lichtenstein repair for inguinal hernia repair: a meta-analysis of randomized controlled trials. Am J Surg 2012; 204:769.
  13. Zhao G, Gao P, Ma B, et al. Open mesh techniques for inguinal hernia repair: a meta-analysis of randomized controlled trials. Ann Surg 2009; 250:35.
  14. Li J, Ji Z, Li Y. Comparison of mesh-plug and Lichtenstein for inguinal hernia repair: a meta-analysis of randomized controlled trials. Hernia 2012; 16:541.
  15. Bittner R, Sauerland S, Schmedt CG. Comparison of endoscopic techniques vs Shouldice and other open nonmesh techniques for inguinal hernia repair: a meta-analysis of randomized controlled trials. Surg Endosc 2005; 19:605.
  16. Schmedt CG, Leibl BJ, Bittner R. Endoscopic inguinal hernia repair in comparison with Shouldice and Lichtenstein repair. A systematic review of randomized trials. Dig Surg 2002; 19:511.
  17. Grant AM, EU Hernia Trialists Collaboration. Open mesh versus non-mesh repair of groin hernia: meta-analysis of randomised trials based on individual patient data [corrected]. Hernia 2002; 6:130.
  18. Berney CR. The Endoloop technique for the primary closure of direct inguinal hernia defect during the endoscopic totally extraperitoneal approach. Hernia 2012; 16:301.
  19. Reddy VM, Sutton CD, Bloxham L, et al. Laparoscopic repair of direct inguinal hernia: a new technique that reduces the development of postoperative seroma. Hernia 2007; 11:393.
  20. Beacon J, Hoile RW, Ellis H. A trial of suction drainage in inguinal hernia repair. Br J Surg 1980; 67:554.
  21. Falagas ME, Kasiakou SK. Mesh-related infections after hernia repair surgery. Clin Microbiol Infect 2005; 11:3.
  22. Sanchez-Manuel FJ, Seco-Gil JL. Antibiotic prophylaxis for hernia repair. Cochrane Database Syst Rev 2003; :CD003769.
  23. Sanabria A, Domínguez LC, Valdivieso E, Gómez G. Prophylactic antibiotics for mesh inguinal hernioplasty: A meta-analysis. Ann Surg 2007; 245:392.
  24. Gilbert AI, Felton LL. Infection in inguinal hernia repair considering biomaterials and antibiotics. Surg Gynecol Obstet 1993; 177:126.
  25. Delikoukos S, Tzovaras G, Liakou P, et al. Late-onset deep mesh infection after inguinal hernia repair. Hernia 2007; 11:15.
  26. Moon V, Chaudry GA, Choy C, Ferzli GS. Mesh infection in the era of laparoscopy. J Laparoendosc Adv Surg Tech A 2004; 14:349.
  27. Neumayer L, Giobbie-Hurder A, Jonasson O, et al. Open mesh versus laparoscopic mesh repair of inguinal hernia. N Engl J Med 2004; 350:1819.
  28. Costerton JW, Stewart PS, Greenberg EP. Bacterial biofilms: a common cause of persistent infections. Science 1999; 284:1318.
  29. Donlan RM. Biofilm formation: a clinically relevant microbiological process. Clin Infect Dis 2001; 33:1387.
  30. Vuong C, Gerke C, Somerville GA, et al. Quorum-sensing control of biofilm factors in Staphylococcus epidermidis. J Infect Dis 2003; 188:706.
  31. Taylor SG, O'Dwyer PJ. Chronic groin sepsis following tension-free inguinal hernioplasty. Br J Surg 1999; 86:562.
  32. Nolla-Salas J, Torres-Rodríguez JM, Grau S, et al. Successful treatment with liposomal amphotericin B of an intraabdomianl abscess due to Candida norvegensis associated with a Gore-Tex mesh infection. Scand J Infect Dis 2000; 32:560.
  33. Matthews MR, Caruso DM, Tsujimura RB, et al. Ventral hernia synthetic mesh repair infected by Mycobacterium fortuitum. Am Surg 1999; 65:1035.
  34. Deysine M. Pathophysiology, prevention, and management of prosthetic infections in hernia surgery. Surg Clin North Am 1998; 78:1105.
  35. Kuo YC, Mondschein JI, Soulen MC, et al. Drainage of collections associated with hernia mesh: is it worthwhile? J Vasc Interv Radiol 2010; 21:362.
  36. Cingi A, Manukyan MN, Güllüoğlu BM, et al. Use of resterilized polypropylene mesh in inguinal hernia repair: a prospective, randomized study. J Am Coll Surg 2005; 201:834.
  37. Terzi C, Kiliç D, Unek T, et al. Single-dose oral ciprofloxacin compared with single-dose intravenous cefazolin for prophylaxis in inguinal hernia repair: a controlled randomized clinical study. J Hosp Infect 2005; 60:340.
  38. Rehman S, Khan S, Pervaiz A, Perry EP. Recurrence of inguinal herniae following removal of infected prosthetic meshes: a review of the literature. Hernia 2012; 16:123.
  39. Salvati EA, Chekofsky KM, Brause BD, Wilson PD Jr. Reimplantation in infection: a 12-year experience. Clin Orthop Relat Res 1982; :62.
  40. Agrawal A, Avill R. Mesh migration following repair of inguinal hernia: a case report and review of literature. Hernia 2006; 10:79.
  41. Kocot A, Gerharz EW, Riedmiller H. Urological complications of laparoscopic inguinal hernia repair: a case series. Hernia 2011; 15:583.
  42. Eugene JR, Gashti M, Curras EB, et al. Small bowel obstruction as a complication of laparoscopic extraperitoneal inguinal hernia repair. J Am Osteopath Assoc 1998; 98:510.
  43. Schmedt CG, Sauerland S, Bittner R. Comparison of endoscopic procedures vs Lichtenstein and other open mesh techniques for inguinal hernia repair: a meta-analysis of randomized controlled trials. Surg Endosc 2005; 19:188.
  44. Olsen JHH, Andresen K, Öberg S, et al. Mortality and Urological Complications After Open Groin Hernia Repair in Local, General, and Regional Anesthesia: A Nationwide Linked Register Study. Scand J Surg 2021; 110:22.
  45. Jensen P, Mikkelsen T, Kehlet H. Postherniorrhaphy urinary retention--effect of local, regional, and general anesthesia: a review. Reg Anesth Pain Med 2002; 27:612.
  46. Di Natale S, Slieker J, Soppe S, et al. Risk Factors for Postoperative Urinary Retention After Endoscopic Hernia Repair: Age and Unilateral Operation make the Difference. World J Surg 2021; 45:3616.
  47. Roadman D, Helm M, Goldblatt MI, et al. Postoperative urinary retention after laparoscopic total extraperitoneal inguinal hernia repair. J Surg Res 2018; 231:309.
  48. Patel JA, Kaufman AS, Howard RS, et al. Risk factors for urinary retention after laparoscopic inguinal hernia repairs. Surg Endosc 2015; 29:3140.
  49. Surgical Options for Inguinal Hernia: Comparative Effectiveness Review, Treadwell J, Tipton K, Oyesanmi O, Sun F, Schoelles K. (Eds), Agency for Healthcare Research and Quality (US), Rockville (MD) 2012.
  50. Oehlenschläger J, Hjørne FP, Albers M, et al. Fewer urological complications after laparoscopic inguinal hernia repair without indwelling catheter. Dan Med Bull 2010; 57:A4176.
  51. Clancy C, Coffey JC, O'Riordain MG, Burke JP. A meta-analysis of the efficacy of prophylactic alpha-blockade for the prevention of urinary retention following primary unilateral inguinal hernia repair. Am J Surg 2018; 216:337.
  52. Fafaj A, Lo Menzo E, Alaedeen D, et al. Effect of Intraoperative Urinary Catheter Use on Postoperative Urinary Retention After Laparoscopic Inguinal Hernia Repair: A Randomized Clinical Trial. JAMA Surg 2022; 157:667.
  53. Gutlic A, Rogmark P, Gutlic N, et al. Pain with sexual activity at 1 and 3 years: Comparing total extraperitoneal with Lichtenstein inguinal hernia repair in a randomized setting (TEPLICH trial). Surgery 2022; 172:1463.
  54. Eklund A, Rudberg C, Smedberg S, et al. Short-term results of a randomized clinical trial comparing Lichtenstein open repair with totally extraperitoneal laparoscopic inguinal hernia repair. Br J Surg 2006; 93:1060.
  55. Grant AM, Scott NW, O'Dwyer PJ, MRC Laparoscopic Groin Hernia Trial Group. Five-year follow-up of a randomized trial to assess pain and numbness after laparoscopic or open repair of groin hernia. Br J Surg 2004; 91:1570.
  56. Shin D, Lipshultz LI, Goldstein M, et al. Herniorrhaphy with polypropylene mesh causing inguinal vasal obstruction: a preventable cause of obstructive azoospermia. Ann Surg 2005; 241:553.
  57. Ssentongo AE, Kwon EG, Zhou S, et al. Pain and Dysfunction with Sexual Activity after Inguinal Hernia Repair: Systematic Review and Meta-Analysis. J Am Coll Surg 2020; 230:237.
  58. Isil RG, Avlanmis O. Effects of totally extraperitoneal and lichtenstein hernia repair on men's sexual function and quality of life. Surg Endosc 2020; 34:1103.
  59. Verhagen T, Loos MJ, Scheltinga MR, Roumen RM. Surgery for chronic inguinodynia following routine herniorrhaphy: beneficial effects on dysejaculation. Hernia 2016; 20:63.
  60. Sheynkin YR, Hendin BN, Schlegel PN, Goldstein M. Microsurgical repair of iatrogenic injury to the vas deferens. J Urol 1998; 159:139.
  61. Štula I, Družijanić N, Sapunar A, et al. Antisperm antibodies and testicular blood flow after inguinal hernia mesh repair. Surg Endosc 2014; 28:3413.
  62. Chehval MJ, Doshi R, Kidd CF, et al. Antisperm autoantibody response after unilateral vas deferens ligation in rats: when does it develop? J Androl 2002; 23:669.
  63. Hallén M, Westerdahl J, Nordin P, et al. Mesh hernia repair and male infertility: a retrospective register study. Surgery 2012; 151:94.
  64. Hallén M, Sandblom G, Nordin P, et al. Male infertility after mesh hernia repair: A prospective study. Surgery 2011; 149:179.
  65. Matsuda T. Diagnosis and treatment of post-herniorrhaphy vas deferens obstruction. Int J Urol 2000; 7 Suppl:S35.
  66. Koning GG, Wetterslev J, van Laarhoven CJ, Keus F. The totally extraperitoneal method versus Lichtenstein's technique for inguinal hernia repair: a systematic review with meta-analyses and trial sequential analyses of randomized clinical trials. PLoS One 2013; 8:e52599.
  67. Wake BL, McCormack K, Fraser C, et al. Transabdominal pre-peritoneal (TAPP) vs totally extraperitoneal (TEP) laparoscopic techniques for inguinal hernia repair. Cochrane Database Syst Rev 2005; :CD004703.
  68. Ramshaw B, Shuler FW, Jones HB, et al. Laparoscopic inguinal hernia repair: lessons learned after 1224 consecutive cases. Surg Endosc 2001; 15:50.
  69. Lau H, Lee F. A prospective endoscopic study of retropubic vascular anatomy in 121 patients undergoing endoscopic extraperitoneal inguinal hernioplasty. Surg Endosc 2003; 17:1376.
  70. Doehn C, Fornara P, Miglietti G, Jocham D. Uraemia after laparoscopic bilateral hernia repair. Nephrol Dial Transplant 1998; 13:1265.
  71. Schwab JR, Beaird DA, Ramshaw BJ, et al. After 10 years and 1903 inguinal hernias, what is the outcome for the laparoscopic repair? Surg Endosc 2002; 16:1201.
  72. Nilsson H, Angerås U, Sandblom G, Nordin P. Serious adverse events within 30 days of groin hernia surgery. Hernia 2016; 20:377.
  73. Nilsson H, Stylianidis G, Haapamäki M, et al. Mortality after groin hernia surgery. Ann Surg 2007; 245:656.
  74. van den Heuvel B, Dwars BJ, Klassen DR, Bonjer HJ. Is surgical repair of an asymptomatic groin hernia appropriate? A review. Hernia 2011; 15:251.
  75. INCA Trialists Collaboration. Operation compared with watchful waiting in elderly male inguinal hernia patients: a review and data analysis. J Am Coll Surg 2011; 212:251.
  76. Bay-Nielsen M, Kehlet H. Anaesthesia and post-operative morbidity after elective groin hernia repair: a nation-wide study. Acta Anaesthesiol Scand 2008; 52:169.
  77. McGugan E, Burton H, Nixon SJ, Thompson AM. Deaths following hernia surgery: room for improvement. J R Coll Surg Edinb 2000; 45:183.
  78. Stylopoulos N, Gazelle GS, Rattner DW. A cost--utility analysis of treatment options for inguinal hernia in 1,513,008 adult patients. Surg Endosc 2003; 17:180.
  79. Inaba T, Okinaga K, Fukushima R, et al. Chronic pain and discomfort after inguinal hernia repair. Surg Today 2012; 42:825.
  80. Alfieri S, Amid PK, Campanelli G, et al. International guidelines for prevention and management of post-operative chronic pain following inguinal hernia surgery. Hernia 2011; 15:239.
  81. Clyde DR, de Beaux A, Tulloh B, O'Neill JR. Minimising recurrence after primary femoral hernia repair; is mesh mandatory? Hernia 2020; 24:137.
Topic 89384 Version 18.0

References

آیا می خواهید مدیلیب را به صفحه اصلی خود اضافه کنید؟