Comparison of polydioxanone (PDS®) and polypropylene (Prolene®) for Shouldice repair of primary inguinal hernias: A prospective randomised trial

Abstract

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.