Inguinal Hernioplasty Using Cremasteric Muscle and Fascia: Is It Effective?

Introduction: Although there are many techniques of inguinal hernioplasty, the ideal one is not yet reached. Cremasteric muscle and fascia was used many years ago aiming to reduce mesh uses and avoid tension in traditional repairs. Aim of the Study: To evaluate the effectiveness of inguinal hernioplasty using cremasteric muscle and fascia. Patients and Methods: This is a prospective randomized study conducted on 64 male patients suffering from different types and degrees of inguinal hernias. After pre-operative evaluation and stratification, they were divided randomly into two therapeutic groups, 32 patients each; group (A) was treated by cremasteric muscle and fascia repair, and group (B) was treated by open on-lay mesh patch tension-free repair. All patients were followed for two years for complications, recurrence and patient satisfaction. Results: This study included 64 male patients their age ranged between 18 to 69 years with mean age = 37±2.3 years. Comparison between the two therapeutic groups showed similar results apart from chronic groin pain was more in group B and patient satisfaction was more in group A with statistical significance in both. Conclusion: Inguinal hernioplasty using cremasteric muscle and fascia is simple, not requiring extensive dissection or supporting by mesh patch with good post-operative patient satisfaction. So it is an effective alternative repair specially in risky situations to use mesh. It is not only a pure tissue tension free repair but also a physiologic one.