Comparative Study of Inguinodynia After Inguinal Hernia Repair

NCT ID: NCT03678272

Last Updated: 2018-09-19

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

270 participants

Study Classification

INTERVENTIONAL

Study Start Date

2013-04-30

Study Completion Date

2016-03-31

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

To evaluate the postoperative pain and the relapse after the repair of the inguinal hernia by Lichtenstein technique with four different mesh types with different types of fixation in patients undergoing major ambulatory surgery.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

Since the widespread use of meshes in the repair of inguinal hernia, recurrence rates have acceptable values, so, today, the focus is on trying to decrease chronic pain after hernioplasty. Chronic postoperative inguinal pain (CPIP) is an important clinical problem, which can significantly influence the quality of life of the patient. Different studies have published CPIP rates from 9.7% to 51.6%.

The reasons for CPIP are unclear; Lesion and entrapment of the nerves, the type of mesh used, and the fixation material of this has been related to the causes of inguinodynia.

CPIP can be divided into neuropathic pain and non-neuropathic pain. According to the International Association for the Study of Pain (IASP), neuropathic pain is caused by the primary lesion or nerve dysfunction, causing burn-like pain that radiates through the area innervated by the injured nerve, intensifying the nerve with light touch. The causes of this type of pain are the entrapment of the nerve by the mesh or sutures or by the formation of neuromas associated with the partial or complete transection of the nerve. The nerves that run through the inguinal region and are therefore susceptible to injury when the anterior approach is the ilioinguinal nerve, the genitofemoral genital branch, and the iliohypogastric nerve.

Neuropathic pain may occur immediately after surgery, but may also occur months or years after surgery.

Non-neuropathic or nociceptive pain is caused by the activation of mediators of inflammation due to the continuous inflammatory reaction that occurs around the mesh. According to Amid, nociceptive pain is caused by the mechanical pressure of the mesh over adjacent tissue, including the vas deferens and nerves. This type of pain is acute and stabbing and is aggravated by intense exercise.

In conclusion, the use of foreign materials in hernia surgery may induce intense inflammation that can result in chronic pain.

The hypothesis of our work is that: "The use of glue-attached meshes (self-adhesive) compared to those fixed with suture present lower rates of post-hernioplasty pain".

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Inguinal Hernia Inguinal Hernia Repair Open Inguinal Hernia

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Outcome Assessors

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

HERNIOPLASTY WITH PANAVALE MESH

Preformed polypropylene mesh.

Group Type ACTIVE_COMPARATOR

HERNIOPLASTY WITH PANAVALE MESH

Intervention Type PROCEDURE

Polypropylene mesh fixed with 3 points. Preformed polypropylene mesh will be used by fixing it with one point to the pubis, another to the inguinal ligament and another to the joint tendon.

HERNIOPLASTY WITH PARIETEX PROGRIP MESH

Mesh consisting of mono lament polyester with a resorbable polylactic acid (PLA) microgrip technology.

Group Type ACTIVE_COMPARATOR

HERNIOPLASTY WITH PARIETEX PROGRIP MESH

Intervention Type PROCEDURE

Preformed polypropylene mesh will be used which presents a self adhesive system not based on glue, but on the arrangement of the fibers of the mesh as "hooks", and to which we will give a single point to the pubis.

HERNIOPLASTY WITH ADHESIX MESH

Self-adhesive mesh.

Group Type ACTIVE_COMPARATOR

HERNIOPLASTY WITH ADHESIX MESH

Intervention Type PROCEDURE

It will use a self-adhesive mesh without giving points to fix this one, since it is a mesh that integrates the glue.

HERNIOPLASTY WITH TIMESH MESH

Titaniumized polypropylene mesh.

Group Type ACTIVE_COMPARATOR

HERNIOPLASTY WITH TIMESH MESH

Intervention Type PROCEDURE

Titaniumized polypropylene mesh will be used without fixing points, since liquid cyanoacrylate (Ifabond) will be used to fix it.

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

HERNIOPLASTY WITH PANAVALE MESH

Polypropylene mesh fixed with 3 points. Preformed polypropylene mesh will be used by fixing it with one point to the pubis, another to the inguinal ligament and another to the joint tendon.

Intervention Type PROCEDURE

HERNIOPLASTY WITH PARIETEX PROGRIP MESH

Preformed polypropylene mesh will be used which presents a self adhesive system not based on glue, but on the arrangement of the fibers of the mesh as "hooks", and to which we will give a single point to the pubis.

Intervention Type PROCEDURE

HERNIOPLASTY WITH ADHESIX MESH

It will use a self-adhesive mesh without giving points to fix this one, since it is a mesh that integrates the glue.

Intervention Type PROCEDURE

HERNIOPLASTY WITH TIMESH MESH

Titaniumized polypropylene mesh will be used without fixing points, since liquid cyanoacrylate (Ifabond) will be used to fix it.

Intervention Type PROCEDURE

Other Intervention Names

Discover alternative or legacy names that may be used to describe the listed interventions across different sources.

Coated Vicryl (poliglactin 910) Suture 2-0 ( Ethicon) Coated Vicryl (poliglactin 910) Suture 2-0 ( Ethicon) Ifabond Synthetic Surgical Adhesive 1,5 ml (Péters Surgical)

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

* Age: over 18 years
* Patients undergoing INGUINAL HERNIA surgery on a scheduled basis in surgery without hospitalization.
* Sign informed consent.
* ASA I-II.
* Inguinal hernia.
* Unilateral or bilateral hernia.
* Lichtenstein hernia repair technique

Exclusion Criteria

* Patients with ASA III-IV.
* Psychiatric disorders.
* Pregnant or breastfeeding.
* Non-acceptance of informed consent.
* No acceptance or inability to follow a follow-up protocol.
* Any hernia repair technique other than Lichtenstein.
* Recurrent inguinal hernia
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

Hospital General Universitario Elche

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Dr. Antonio Arroyo

Head of General surgery

Responsibility Role PRINCIPAL_INVESTIGATOR

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

HGUE-UP-13-01

Identifier Type: -

Identifier Source: org_study_id

More Related Trials

Additional clinical trials that may be relevant based on similarity analysis.

Chronic Pain After Inguinal Hernia Repair
NCT00820131 COMPLETED PHASE4