Mesh fixation vs. non-fixation in total extra peritoneal mesh hernioplasty

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 withmetal nonabsorbable 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 wasmore 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.