Inguinal hernia is a very common disease that mainly affects men in young and middle age and it's reparation is the most frequent operation in general surgery. Hernias present as bulges in the groin area that can become more prominent when coughing, straining, standing up and in all situation where the abdominal pressure grow. If uncomplicated they are rarely painful, and the bulge commonly disappears on lying down. There are various surgical strategies which may be considered in the planning of inguinal hernia repair. These include the consideration of mesh use (mesh is a prosthesis made up by net of synthetic material that help to contrast a abdominal wall tension). A tension free repair method have been proposed to achieve better results in terms of pain and infections and to avoid the problem to present again (recurrence).
We found that the Shouldice technique is the best way to cure an inguinal hernia without using a prosthesis in terms of recurrence. The use of prosthesis reduces the recurrence even more. The persisting pain, post-operative stay and complications after the intervention do not show significant differences between the techniques. Nevertheless the methodological quality of the most included studies is low, length of follow-up is different among studies and findings lacks in patients oriented outcome so the unwelcome results, particularly in patients with chronic disease, for example diabetic or patients under steroidal therapy, should be considered with caution.