Outcomes of treatment for recurrent inguinal hernia: A retrospective cohort study

Abstract CONTEXT: Inguinal hernia is a common surgical condition, with over 20 million repairs worldwide annually. Recurrent inguinal hernias occur in 14% of men and 7% of women, with recurrence rates three times higher than primary cases. Recommendations for the surgical approach to recurrent hernias lack strong evidence. AIMS: This study examines the outcomes of recurrent inguinal hernia surgeries and the patient factors influencing the choice of surgical technique. METHODS: We conducted a retrospective cohort study at Pirogov City Clinical Hospital (2017–2023). Patient data were collected from medical records and surveys on short-term outcomes. The focus was on recurrence rates and chronic pain syndrome (CPS). Follow-up included physical exams and ultrasound. STATISTICAL ANALYSIS USED: Data were analyzed using MS Excel and Jamovi 2.3.21. Categorical data are shown as counts and percentages, and continuous data as median (Me) and interquartile range (Q1–Q3). Statistical tests included the Student t test, Mann–Whitney test, Pearson’s chi-square, and the log-rank test for recurrence rates. A P -value < 0.05 was considered significant. RESULTS: A total of 187 patients had TAPP ( n = 130) or Lichtenstein ( n = 57) repairs. TAPP was preferred for prior mesh or non-mesh repairs, and Lichtenstein for prior TAPP. Our assessment of surgical trends showed a preference for open mesh repair in older patients ( P = 0.04), those presenting with extensive hernias ( P < 0.01), indirect inguinal hernias ( P = 0.016), and individuals with a prior diagnosis of prostatic disorders ( P < 0.01). Nevertheless, this sample of patients demonstrated a statistically significant increase in postoperative sensory disturbances (10.64%, P = 0.05). Seven recurrences (6.6%) occurred in the TAPP group, though not significantly different. Long-term outcomes were similar between groups. CONCLUSION: The optimal surgical approach for recurrent inguinal hernia remains unclear. Patient characteristics play a significant role in surgical decision-making.