A very large and important study was published by the in the European Hernia Trialists Collaboration in Annals of Surgery in 2002 and was titled “Repair of groin hernia with synthetic mesh: meta-analysis of randomized controlled trials.”
In this study, the group produced 62 relevant comparisons in 58 eligible trials to specifically look at the rate of recurrence (meaning the hernia came back) for inguinal (groin) hernia repair in thousands of patients, comparing “mesh versus non-mesh repairs.” They also compared the different techniques used for both the mesh and non-mesh repairs, as well as the complication of persisting pain after surgery for both mesh and non-mesh repairs.
There were 11,174 total patients, but individual patient data were available for 6,901 patients, supplementary aggregated data for 2,390 patients, and published data for 1883 patients.
There were 4,426 repairs with mesh, and in that group, there were 88 recurrences, for a rate of 2%
There were 3,795 repairs without mesh, and in that group, there were 187 recurrences, for a rate of 4.9%
Persisting pain was noted lower the mesh group compared to the non-mesh group.
So, the "Non-mesh" repairs had more than TWICE the rate of recurrence compared with “mesh” repairs!
The conclusion was therefore that the use of synthetic mesh substantially reduces the risk of hernia recurrence irrespective of placement method. Mesh repair appears to reduce the chance of persisting pain rather than increase it.
EU Hernia Trialists Collaboration. Repair of groin hernia with synthetic mesh: meta-analysis of randomized controlled trials. Ann Surg. 2002 Mar;235(3):322-32. doi: 10.1097/00000658-200203000-00003. PMID: 11882753; PMCID: PMC1422456.