Mahmood Ayyaz, Muhammad Waris Farooka, Awais Amjad Malik, Ahsan Khan, Rashid Mansoor, Asad Ali Toor, Haseeb Anwar Khokhar.
Mesh fixation vs. non-fixation in total extra peritoneal mesh hernioplasty.
J Pak Med Assoc Jan ;65(3):270-2.

Objective: To compare mesh fixation with non-fixation and its effect on outcome. Methods: The interventional prospective study was conducted at the National Hospital & Medical Centre, Lahore from January 2007 to December 2008. After the two-year intervention period, the patients were followed up for 5 years. The selected patients were divided into two groups. In group 1, mesh fixation was performed with metal non-absorbable tackers and in group II no fixation of mesh was performed. Patients were followed up at 6, 12, 24 and 60 months. Results: Of the 63 patients in the study, 32(50.7%) were in group I and 31(49.2% in group II. The Mean pain score in group I was 4.7±0.683 and 4.1±0.860 in group II (p< 0.001). Urinary retention was more common in group 1 (p>0.05), while recurrence was more common in group II (p>0.05). Conclusion: Pain was significantly less in the non-fixation group, while urinary retention and recurrence were not significantly increased. Non-fixation is a viable option for total extraperitoneal mesh hernioplasty and should be preferred over mesh fixation.

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