Objective: To compare the recurrence rates after Shouldice operation for primary inguinal hernias, using non-absorbable polypropylene or absorbable polydioxanone suture material.
Design: Randomised, controlled trial.
Setting: Teaching hospital, Germany.
Subjects: 220 male patients who had 233 elective Shouldice repairs of primary inguinal hernias, 201 of whom were followed up.
Intervention: Standard Shouldice procedure with 2/0 polypropylene (Prolene, n = 98) or 2/0 polydioxanone (PDS, n = 103).
Main outcome measures: Recurrence rates after a minimum follow-up of 24 months (range 24-48, mean 31).
Results: Numbers of early complications were similar in the two groups; there were 2 wound infections in each. A total of 193 patients with 201 repairs had a documented follow-up (86%). There were 6 recurrences in the PDS group and 5 in the Prolene group, giving a total recurrence rate of 5%. This difference was not significant (Fisher's exact test, p = 1.0).
Conclusion: Recurrence rates in both groups were higher than expected, but there was no difference between the two groups.