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Erschienen in:
12.02.2019 | Original Scientific Report
Nationwide Propensity-Score Matched Study of Mesh Versus Suture Repair of Primary Ventral Hernias in Women with a Subsequent Pregnancy
Erschienen in: World Journal of Surgery | Ausgabe 6/2019
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Background
Mesh reinforcement is recommended for repair of primary ventral hernias; however, this recommendation does not consider a potential subsequent pregnancy. The aim of this prospective cohort study was to compare mesh and suture repair of a primary ventral hernia in women with a subsequent pregnancy.
Methods
All women of childbearing age who underwent repair of a primary ventral hernia between 2007 and 2014 were identified in the Danish Ventral Hernia Database. Data were merged with the Danish Medical Birth Registry. Women with a subsequent pregnancy and a propensity-score matched control group of women without a subsequent pregnancy were included. A structured questionnaire was sent out, and the primary outcome was hernia recurrence, while the secondary outcome was chronic postoperative pain.
Results
In total, 632 women were included, of whom 441 (69.8%) responded to the questionnaire (195 and 246 with and without subsequent pregnancy, respectively). The 8-year cumulative incidence of recurrence was 24.8%. In women with a subsequent pregnancy, mesh repair was associated with a decreased risk of recurrence (hazard ratio 0.44, 95% CI 0.20–0.95, p = 0.038, number needed to treat = 5.1) and an increased risk of chronic pain (OR 5.07, 95% CI 1.20–23.38, p = 0.029, number needed to harm = 4.7) compared with suture repair, in multivariable analyses.
Conclusions
Mesh repair was associated with a decreased risk of recurrence, but an increased risk of chronic pain, compared with suture repair in women with a subsequent pregnancy.