Comparative analysis of unilateral inguinal hernia repair using Lichtenstein and Prolene hernia system techniques in a public teaching hospital: a retrospective cohort study

Muniz, LorenaSantos, Thiago Henrique dosSantos, Isabela Silva dosCremon, Bruna GarridoSalgado Junior, Wilson

ABSTRACT Purpose: To compare early- and medium-term postoperative outcomes of unilateral inguinal hernia repair performed using the Lichtenstein and Prolene hernia system (PHS) techniques in a public teaching hospital. Methods: A retrospective analysis of 897 patients undergoing primary unilateral inguinal hernioplasty (406 with Lichtenstein and 491 with PHS) from January 2011 to March 2025 was conducted. Clinical, intraoperative, and postoperative data were collected and compared. Statistical analysis included t-tests, Mann-Whitney, Fisher's exact, and χ2 tests. Results: Groups were not entirely homogeneous in preoperative profiles. The mean age was similar (p = 0.85), with predominance of males (94.87%). The operative time was significantly shorter for the PHS group (68.83 ± 24.84 versus 76.23 ± 26.90 min; p < 0.01). No significant differences were observed in postoperative complications, chronic pain, sensory dysfunction, or recurrence. Hospitalization was less frequent with the PHS technique (4.27 versus 12.8%; p < 0.01). Greater preference for local anesthesia was observed in the PHS group (20.77 versus 4.68%; p < 0.01). Conclusion: Both techniques proved effective and safe, but the PHS technique showed advantages regarding operative time and hospitalization rate. However, limited sample size and absence of cost and return-to-activity data restrict broader generalizations. Further prospective randomized studies are needed.