***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: BACKGROUND The aim of this study was to investigate the reoperation rates after open indirect inguinal hernia repair with and without mesh in young males and other age groups . Younger males have higher risk of developing chronic pain after open inguinal hernia repair with mesh compared with older patients . Avoiding mesh among younger patients could be justified , if they have an acceptable low risk of recurrence compared with other groups and compared with Lichtenstein repair . METHODS Data were extracted from the nationwide Danish Hernia Data base which is recording prospect ively . Included were males with primary indirect inguinal hernia , repaired with Lichtenstein or annulorrhaphy from the period January 1 , 1998 to December 31 , 2015 .  Reoperation rate for recurrence was used as outcome . RESULTS In total 52,281 primary repairs of open indirect inguinal hernia were included of which 49,951 were Lichtenstein repairs and 2330 were annulorrhaphies .  The overall reoperation rates increased year after year in both groups but the 18 - 29 year old males had a significant lower risk of reoperation after annulorrhaphy compared with all other age groups ( cumulative reoperation rate 8.1 % versus 12.5 % , log rank p = 0.001 ) . CONCLUSIONS The cumulative reoperation rate after annulorrhaphy for 18 - 29 year old males was significantly lower compared with all other age groups . When taken into consideration , that young males at the same time have the highest risk of developing chronic pain after mesh repair the results indicate , that annulorrhaphy could be a valid option for young men with indirect inguinal hernias . Thus , we propose a tailored approach for this patient group Background In recent years long-term discomfort  after inguinal hernia surgery has become an issue of great concern to hernia surgeons . Long-term results on discomfort from large r and omised studies are sparse . Methods One-thous and one-hundred and eighty-three patients were r and omised in a multicentre trial with the primary aim of comparing recurrence rates after laparoscopic TAPP and Shouldice repair . Evaluating late discomfort and its possible risk factors were secondary objectives , and are reported here . The patients were clinical ly examined after 1 and 5 years , and answered question naires 2 and 3 years postoperation . Results Of 1,068 operated patients , 867 were eligible for analysis after 5 years ( 81.2 % ) . The percentage of patients experiencing discomfort of any kind were 8.5 % in the TAPP group and 11.4 % ( p = 0.156 ) in the Shouldice group . Although discomfort was usually mild it was severe for 0.2 and 0.7 % , respectively . Severe pain the first postoperative week was a risk factor for late discomfort in the Shouldice group ( OR 2.25 , P = 0.022 ) but not in the TAPP group . No other risk factor for late discomfort was found . Conclusion There was no difference between late discomfort at five-year follow-up after laparoscopic TAPP and Shouldice repair .  Discomfort was mostly mild and pain during the first postoperative week was a prognostic variable for late discomfort in Shouldice patients BACKGROUND The Cooperative Hernia Study assessed postoperative pain in a prospect i ve trial as part of a larger study looking at the recurrence rate and other morbidity of the Bassini , McVay , and Shouldice repairs . METHODS Patients were r and omized to one of three surgical hernia repairs .  Patients were seen in follow-up at 6 , 12 , and 24 months and were assessed for the presence of pain , numbness , paresthesia , and recurrence . RESULTS Three hundred fifteen patients were seen in follow-up , with 276 seen at the 2-year mark . At 1 year , 62.9 % of patients had groin or inguinal pain and 11.9 % of patients had moderate to severe pain ; 53.6 % had pain and 10.6 % of patients continued to report moderate to severe pain 2 years postoperatively . The predictors for long-term postoperative pain were as follows : absence of a visible bulge before the operation ( p < 0.001 ) ; presence of numbness in the surgical area postoperatively ( p < 0.05 ) ; and patient requirement of more than 4 weeks out of work postoperatively ( p < 0.004 ) . Three distinct chronic pains were identified . The most common and most severe pain was somatic , localized to the common ligamentous insertion to the public tubercle . The second was neuropathic and was referable to the ilioinguinal or genitofemoral nerve distribution . This was likely because of injury to the genitofemoral nerves , either at surgery or subsequently by encroachment of scar . The third pain was visceral , ejaculatory pain . Twenty-four percent of patients had postoperative numbness at 2 years , independent of the type of repair . Numbness was most common in the distribution of cutaneous branches of the ilioinguinal and iliohypogastric nerves . CONCLUSION Pain or numbness are common late sequelae of traditional external surgical hernia repairs . Strategies need to be developed to reduce the risk of these complications BACKGROUND The ideal operation to treat inguinal hernia is still far to define . We analyzed the outcomes of the Desarda tissue-based repair in comparison with the st and ard Lichtenstein procedure in treatment of primary  inguinal hernia .  METHODS A total of 168 patients were r and omly allocated into two groups to undergo one of two repairs : Desarda ( group I ) or Lichtenstein ( group II ) ( 85 vs. 83 , respectively ) . The primary outcome measures were recurrence of inguinal hernia and chronic groin pain . Secondary outcome measures included operating time , postoperative pain scores , time to return to normal gait and to work , foreign body sensation in the groin , and postoperative complications . RESULTS During 2-year follow up , one recurrence was detected in each group ( P = 0.99 ) . Chronic groin pain was experienced by 5.6 % and 4.2 % of patients from Desarda and Lichtenstein groups respectively ( P = 0.68 ) . There was no significant statistical difference in mean postoperative VAS scores for pain at the five time points between the two study groups . There was significantly shorter operating time and earlier return to normal gait in favor of Desarda repair . Foreign body sensation was not different between the two groups . CONCLUSION Successful inguinal hernia treatment without mesh implantation can be achieved using Desarda repair , as it is effective as the st and ard Lichtenstein procedure . Shorter operating time , early return to normal gait and lower cost ( no mesh ) are potential benefits of Desarda repair . The suitability of Desarda repair for patients found to have thin , weak or divided external oblique aponeurosis intraoperatively needs further evaluation Background The Shouldice method and other tissue-based techniques are still acknowledged to be acceptable for primary inguinal hernia repair according to the European Hernia Society guidelines . Desarda ’s technique , presented in 2001 , is an original hernia repair method using an undetached strip of external oblique aponeurosis . This r and omized trial compared outcomes after hernia repair with Desarda ( D ) and mesh-based Lichtenstein ( L ) techniques . Methods A total of 208 male patients were r and omly assigned to the D or L group ( 105 vs. 103 , respectively ) . The primary outcomes measured were recurrence and chronic pain . Additionally , early and late complications , foreign body sensation , and return to everyday activity were examined in hospital and at 7 , 30 days , and 6 , 12 , 24 , and 36 months after surgery . Results During the follow-up , two recurrences were observed in each group ( p = 1.000 ) . Chronic pain was experienced by 4.8 and 2.9 % of patients from groups D and L , respectively ( p = 0.464 ) . Foreign body sensation and return to activity were not different between the groups . There was significantly less seroma production in the D group ( p = 0.004 ) . Conclusions The results of primary inguinal hernia repair with the Desarda and Lichtenstein techniques are comparable at the 3-year follow-up . The technique may potentially increase the number of tissue-based methods available for treating groin hernias OBJECTIVES --To gain population norms for the short form 36 health survey question naire ( SF36 ) in a large community sample and to explore the question naire 's internal consistency and validity . DESIGN --Postal survey by using a booklet containing the SF36 and several other items concerned with lifestyles and illness . SETTING --The sample was drawn from computerised registers of the family health services authorities for Berkshire , Buckinghamshire , Northamptonshire , and Oxfordshire . SAMPLE --13,042 r and omly selected subjects aged 18 - 64 years . MAIN OUTCOME MEASURES --Scores for the eight health dimensions of the SF36 . RESULTS --The survey achieved a response rate of 72 % ( n = 9332 ) . Internal consistency of the different dimensions of the question naire was high . Normative data broken down by age , sex , and social class were consistent with those from previous studies . CONCLUSIONS --The SF36 is a potentially valuable tool in medical research . The normative data provided here may further facilitate its validation and use Purpose The use of mesh in the surgical repair of adult indirect inguinal hernias is widely recommended in Western countries , but no r and omized controlled trials have so far been reported in Japan . The purpose of the present r and omized prospect i ve trial was to compare a mesh method with non-mesh method for surgical repair of primary adult indirect inguinal hernias in which the diameter of the internal inguinal ring was up to 3.0 cm ( I-1 or I-2 of Japanese Hernia Society Classification ) . Methods Patients with a primary unilateral inguinal hernia and I-1 or I-2 surgical findings were r and omized to undergo either Marcy repair or Prolene Hernia System ® repair . Primary endpoints were recurrence , infection , and pain , with follow-up continued for 3 years postoperatively . Results Ninety-one of 479 patients with an inguinal hernia during the study period did not meet the exclusion criteria , and 46 were allocated to Marcy repair and 45 were allocated to Prolene Hernia System ® repair .  No recurrence was observed in either group , and no significant differences were identified between the groups in any of the primary endpoints . Conclusion This r and omized prospect i ve trial of I-1 and I-2 inguinal hernias suggests that Marcy repair is not inferior to PHS repair . A large-scale r and omized controlled trial appears warranted to confirm whether to use mesh for Japanese adult I-1 and I-2 hernias Background : Inguinal hernia repair is the most common procedure in general surgery and 80,000 operations are performed annually in Great Britain , 100,000 in France and 700,000 in the US . Given its high frequency has a major impact , both in the medical and economic aspects . Aim : Analyze the immediate postoperative complications comparing mesh versus non mesh hernioplasty . Method : R and omized control trial , with the enrollment of 263 patients underwent surgery for inguinal hernia r and omized by r and omization table . Treatment ( mesh , Lichtenstein or without mesh , Bassini technique ) was assigned using sequentially numbered opaque envelopes having fulfilled the inclusion criteria . The variables analyzed were : postoperative pain , seroma , hematoma , infection , return to normal activities and recurrence . Results : The mean age was 55.5 years , 88 % patients were male and 12 % female . The pain was higher in patients operated with  mesh . Conclusions : The inguinal hernia repair mesh group had less immediate postoperative complications and significantly earlier return to work than hernioplasty without mesh , this being one of the most important conclusions Introduction Chronic pain after  hernia repair  is common , and it is unclear to what extent the different operation techniques influence its incidence . The aim of the present study was to compare the three major st and ardized techniques of hernia repair with regard to postoperative pain . Patients and methods Two hundred and eighty male patients with primary hernias were prospect ively , r and omly selected to undergo Shouldice , tension-free Lichtenstein or laparoscopic transabdominal pre-peritoneal ( TAPP ) hernioplasty repairs .  Patients were examined after 52 months with emphasis on chronic pain and its limitations to their quality of life . Results Chronic pain was present in 36 % of patients after Shouldice repair , in 31 % after Lichtenstein repair and in 15 % after TAPP repair . Pain correlated with physical strain in 25 % of patients after Shouldice , in 20 % after Lichtenstein and in 11 % after TAPP repair . Limitations to daily life , leisure activities and sports occurred in 14 % of patients after Shouldice , 13 % after Lichtenstein and 2.4 % after TAPP repair . Conclusion Chronic pain after hernia surgery is significantly more common with the open approach to the groin by Shouldice and Lichtenstein methods . The presence of the prosthetic mesh was not associated with significant postoperative complaints . The TAPP repair represents the most effective approach of the three techniques in the h and s of an experienced surgeon INTRODUCTION This prospect i ve , r and omized , controlled clinical study aim ed to assess the perioperative and long-term results of primary inguinal hernia repair and to compare the results for a totally extraperitoneal ( TEP ) procedure with the results of patients undergoing darn plication .  MATERIAL S AND METHODS For this study , 166 patients with unilateral inguinal hernias were r and omly assigned to undergo either TEP ( n=78 ) or darn plication ( n=88 ) . RESULTS The mean operation time  for darn plication ( 1 
    Output:
    
Both the meta‐analyses and the network meta‐ analysis indicated no difference in chronic pain rates when comparing nonmesh repairs with open‐ and laparoscopic mesh repairs .
Conclusion : Mesh may be used without fear of causing a greater rate of chronic pain