At the present time, any categorical recommendation for mesh- based hernia repair can be made only subject to certain caveats (). Unanswered questions on the biocompatibility of meshes remain, and this on the background of possible physical reactions to foreign bodies, which make later procedures, such as lymphadenectomy, vascular reconstruction, or radical prostatovesiculectomy, difficult or even altogether impossible. Hydrocele, varicocele, spermatic cord irritations, ilioinguinal pain syndromes after mesh implantations are not rare. And why would they be, in view of the occasionally catastrophic results after using the same alloplastic materials in prolapse surgery in women ().
We currently have an urgent need to catch up in the already widespread use of meshes and require:
a) A system of tests to ascertain the biocompatibility of meshes ()
b) Valid studies before mesh materials are used clinically ()
c) A compulsory, cross-disciplinary implant registry for the purpose of evaluating long term effects, such as is already being called for in the federal government's national strategy process.
DOI: 10.3238 / arztebl.2016.0543b
Prof. Dr. med. Thomas Otto
Dr. med. Dimitri Barski
Dr. med. Bernhard J. Lammers
Städtische Kliniken Neuss
thomas_otto@lukasneuss.de
Conflict of interest statement
The author declares that no conflict of interest exists.
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