We found that female sex , direct inguinal hernias at the primary procedure , operation for a recurrent inguinal hernia , and smoking were significant risk factors for recurrence after inguinal hernia surgery .
Background .
Several factors influence the risk of recurrence after inguinal hernia surgery ; however , a systematic review and meta- analysis of patient-related risk factors for recurrence after inguinal hernia surgery has not been performed earlier .
Repeated Groin Hernia Recurrences
Objective : To describe the characteristics of patients undergoing multiple groin hernia repairs  and to identify strategies that prevent further recurrence . Summary Background Data : Although relatively infrequent , recurrent groin hernias where several repairs have previously been undertaken constitutes a major problem in hernia surgery . Low numbers and heterogeneity have made it difficult to perform large prospect i ve studies on this group . Methods : The study was design ed as an observational population -based register study . All repairs for recurrent hernia recorded in the Swedish Hernia Register ( SHR ) 1992–2006 were identified . Risk for reoperation by number of previous repairs , with adjustment for gender and age , and risk for reoperation by unit responsible for previous repair were determined using Cox proportional hazard analysis . Results : There were 12,104 cases of hernia repaired once , 2 repairs in 4199 cases , 3 repairs in 310 cases , 4 repairs in 32 cases , and 5 repairs in 3 cases . The risk for further reoperation increased with the number of previous repairs ( P < 0.001 ) . The hazard ratios for reoperation following  open preperitoneal mesh repair and  laparoscopic repair  decreased ; whereas , the hazard ratio for sutured repair  increased with the number of previous repairs . The difference between Lichtenstein repair and laparoscopic repair was significant for the first 2 repairs ( P < 0.05 ) . Conclusion : Laparoscopic preperitoneal repair provides the best surgical outcome in repeated groin hernia recurrence
We found that female sex , direct inguinal hernias at the primary procedure , operation for a recurrent inguinal hernia , and smoking were significant risk factors for recurrence after inguinal hernia surgery .
Background .
Several factors influence the risk of recurrence after inguinal hernia surgery ; however , a systematic review and meta- analysis of patient-related risk factors for recurrence after inguinal hernia surgery has not been performed earlier .