[Recurrent inguinal hernia after mesh hernioplasty. An emerging problem?].

Background: In spite of the successful results of tension free hernioplasties, recurrent inguinal hernias are not an uncommon finding in the clinical practice.

Methods: The authors report their experience in 24 patients observed from January 1994 to December 2000 (23 men, 1 women, min. age 28 yrs, max 78 yrs, mean 58 yrs) who had recurrent inguinal hernia after a tension free hernioplasty. In 22 patients a tension free hernioplasty (Lichtenstein technique 5 patients, Trabucco 7 patients, unclassifiable 10 patients) through an anterior approach was performed while in two, respectively, a Stoppa procedure and a laparoscopic hernioplasty were the first operations; mean recurrence time was 17 months.

Results: Mesh and/or plug dislocation was the most frequent cause of recurrence (15 patients), followed by a failure of the internal ring reconstruction (6 patients) and loss of the pubic stitch (2 patients); in 1 patient the mesh was of reabsorbable type.

Conclusions: Mesh hernioplasties represent a valuable progress in inguinal hernia therapy, but increasing clinical experience shows that, together with the experience of the surgeon in the surgical technique, suture of a wide mesh to the surrounding tissues and a adequate inguinal ring reconstruction are critical condition for good results.