ArticleJournal of abdominal wall surgery : JAWS2026
Inguinoscrotal hernia repair: analysis of the national EVEREG registry.
Article in Journal of abdominal wall surgery : JAWS, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Purpose: Inguinoscrotal hernia repair has been associated with worse outcomes compared to conventional repairs. Its optimal technique and prognostic factors remain unclear. We aimed to evaluate factors related to complications and recurrence in these repairs based on the EVEREG registry. Methods: Adult males who underwent elective unilateral inguinoscrotal hernia repair from 2021 to 2024 from the EVEREG registry were included. The primary outcome was postoperative complications. The secondary outcomes were to describe recurrence within 30 days and at latest available follow-up. Results: A total of 748 patients were included. Most patients (83.4%) underwent open repair, and the preferred mesh position was anterior in 70.8% of cases. Postoperative complications occurred in 6.95% of cases, mostly grade I-II of the Clavien-Dindo classification. Advanced age, diabetes, chronic obstructive pulmonary disease, higher ASA grade, H4-type hernia, open surgical approach, intraoperative complications, and longer operative times were identified as factors associated with postoperative complications (P < 0.001, P = 0.018, P = 0.035, P < 0.001, P = 0.007, P = 0.002, P = 0.039, and P < 0.001). Ambulatory surgery and the involvement of a surgeon with experience in abdominal wall repair were associated with better outcomes (P < 0.001, P = 0.029). Multivariate analysis yielded consistent results regarding protective factors. At maximum follow-up, the presence of a surgeon experienced in abdominal wall repair was the only factor linked to lower recurrence risk. Conclusion: According to the EVEREG registry, the most common approach for inguinoscrotal hernia repair was open surgery with anterior mesh placement. Postoperative complications occurred mainly in patients with greater comorbidity and hernia complexity and were mostly low-grade. Surgery performed by a surgeon experienced in abdominal wall surgery was associated with fewer postoperative complications, supporting individualised management and consideration of referral for complex cases. The available data do not allow conclusions regarding the superiority of a specific technique or long-term recurrence.
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