Objective: In this prospective, secuentially randomized study, acute and chronic pain, testiculer arterial flow measurements and sexual functions were compared between Kugel and Lichtenstein hernia repair which are tension free, with Shouldice repair technic which is tensioned classical repair technic. Patients and methods: A prospective series of 92 inguinal hernia repairs performed in 66 patients. Shouldice repair performed to 19, Lichtenstein repair performed to 24 patients and Kugel repair performed to 23 patients. Results: No recurrence was seen in the 66 patients for all three groups. Postoperative 2nd hour (p< 0.001) and 24th hour (p< 0.05) VAS scores were significantly lower in the group K. For the evaluating of the chronic pain in the first year, incidence and limited activity were not significantly different between groups, but we found lesser pain intensity in the group K (p<0.01). There were not any erectile dysfunction in all patients. Erectile function results were also better in the Kugel group first year postoperatively, but these differences between groups were not significant. (p> 0.05) In the Doppler ultrasound measurements, testicular artery volumes were not different in all groups, but decrease of the flow measurements in Shouldice and Lichtenstein groups were significant. Testicular artery flow decreased in all groups at the postoperative period. Conclusion: The technic of preperitoneal Kugel patch repair, is new repair technic which has more satisfied results with less acute and chronic pain, less hospitalisation time, and less time to return to normal daily activity. It is interesting that the three different technics of hernia repairs cause decrease in the testiculer artery flow and volume, and it is significant in Shouldice and Lichtenstein groups, whereas it is not significant in the Kugel group. All repair technics in this study were not effected the erectile function, and there were no differences between groups. It is also interesting that, Kugel patch repair has more advantages on the patient comfort compare to the Lichtenstein repair technic which was accepted a new challenge in the inguinal hernia surgery.
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