Follow-up of inguinal hernia repairs using a modified Kugel mesh without the optional onlay mesh for more than 10 years.

Purpose: In this 10-year follow-up study, we evaluated the long-term postoperative results of single-layer modified Kugel (MK) herniorrhaphy without an onlay mesh.

Methods: Patients who underwent anterior modified Kugel herniorrhaphy without an onlay mesh between May 1, 2009, and June 31, 2012, were included in this study. The criterion for onlay mesh omission was that the posterior inguinal hernia defect did not exceed the memory recoil ring of the MK mesh. Long-term results, including pain, foreign body sensation, and recurrence, were collected and analyzed.

Results: Overall, 175 hernia repairs in 163 patients were analyzed. Within 3 months postoperatively, there was one recurrence (0.6%), nine patients (5.5%) had persistent pain, and six (3.6%) had foreign body sensations. Other complications included one case of orchitis (0.6%), two epididymitis (1.2%), two hydrocele (1.2%), and two hematoma (1.2%) cases. One year postoperatively, three patients had pain (1.8%), and six had foreign body sensations (3.6%). Five years postoperatively, one patient had pain (0.6%), three had foreign body sensations (1.8%), and two had newly observed inguinal bulging (1.2%). Ten years postoperatively, one patient had pain (0.6%), two had foreign body sensations (1.2%), and two had newly observed inguinal bulging (1.2%). The recurrence rate during the long-term follow-up was 0.6%.

Conclusions: In this study, we demonstrated the long-term safety and efficacy of single-layer MK-mesh herniorrhaphy without an onlay mesh. Omitting the onlay mesh minimized the amount of foreign material implanted into patients, resulting in decreased long-term postoperative complications without sacrificing the efficacy of mesh herniorrhaphy.