[P.H.S. (Prolene Hernia System) mesh--initial experience].

In 197 among plastic operations of the groin without tension, using a mesh and new method was added: P.H.S.--Prolene Hernia System--mesh. At the Surgical Clinic of the General Faculty Hospital and First Medical Faculty Charles University in Prague this method is used for plastic operations of the inguinal canal since October 1999. Every year some 300 patients with inguinal hernia are operated, incl. 18.7% operations or multiple relapses. 91% of the group are men and the mean period of hospitalization is 4.9 +/- 3 days. The method "under tension" (McVay, Lotheissen) is used on average in 56.2% patients, in the remainder we use methods "without tension": laparoscopic hernioplasty (TAPP) in 26.7%, Lichtenstein's method in 2.4% and hernioplasty by means of PHS in 14.7% of the patients. Since October 1999 we used it so far in 88 male patients, mean age 55.3 years (2-90 years) with 97 primary or recurrent inguinal hernias. In these patients in 36 instances an indirect hernia was involved (37.1%), a direct hernia was present in 59 patients (60.8%). In two patients we found a saddle hernia (2.1%) and 11 patients (11.4%) had a bilateral hernia. In 12 (12.4%) patients we observed haematoma in the subcutaneous layer in the area of the wound and on the scrotum. In 4 (4.1%) patients there was a seroma in the wound, and subfebrile temperatures up to 38 degrees C were recorded in 9 (9.3%), in 4 patients (4.1%) pain or oedema of the testis developed but receded very rapidly. Postoperative hospitalization lasted on average 2.4 days (1-6 days) and the period before return to normal physical activity was 9.9 days (7-16 days). The patients are checked after regular intervals: 2 weeks, 6 weeks, 6 months, 1 and 2 years. Between October 1999 and February 2002 in the group only one relapse occurred after 6 months.