Post operative pain associated with ProGrip mesh hernioplasty: a systematic review and meta-analysis

Purpose: Postoperative pain is a common complication following inguinal hernia repair. Progrip mesh is a self-adhesive mesh claimed to reduce postoperative pain compared to traditional mesh types. This meta-analysis aimed to compare postoperative pain, operative time, hospital stay, complications, and recurrence rates between Progrip mesh and other mesh types for inguinal hernia repair.

Methods: A systematic search was conducted to identify randomized controlled trials comparing Progrip mesh with other mesh types for inguinal hernia repair. Primary outcome was postoperative pain assessed using the Visual Analogue Scale (VAS). Secondary outcomes included operative time, hospital stay, complications, and recurrence rates. Meta-analyses were performed to calculate pooled effect estimates with heterogeneity assessment.

Results: Twenty-one studies involving 3827 participants were included. Progrip mesh was associated with significantly lower postoperative pain at 6 h (MD = - 1.21, p = 0.05), 1st day (MD = - 0.50, p = 0.03), 7th day (MD = - 0.38, p = 0.01), 2 weeks (MD = - 0.32, p = 0.007), 3 months (MD = - 0.48, p < 0.00001), and 6 months (MD = - 0.43, p < 0.0001) postoperatively compared to other mesh types. However, at 3 days, 1 month, and 1 year, the differences in pain scores were not statistically significant. Operative time was significantly shorter in the Progrip mesh group (MD = - 9.65 min, p < 0.00001). Recurrence rates were significantly higher in the Progrip mesh group (RR = 1.62, p = 0.02). No significant differences were observed in hospital stay (MD = - 0.32, p = 0.22) or postoperative complications (RR = 0.93, p = 0.59).

Conclusion: Progrip mesh demonstrated a significant reduction in operative time and postoperative pain compared to traditional mesh types for inguinal hernia repair. Though, it was associated with higher recurrence rates. There were no significant differences in other outcomes. Further high-quality studies with longer follow-up are needed to assess the long-term effects of Progrip mesh.