Background: Bilateral inguinal hernia occurs in 12% of patients. Simultaneous or sequential repair has been debated especially after tension free repairs.

Aim: This study was conducted to compare Stoppa procedure with bilateral Lichtenstein hernioplasty for the treatment of primary bilateral inguinal hernia.

Patients and Methods: This study included forty patients with primary bilateral inguinal hernias. They were divided randomly into two equal groups. Group A were operated by bilateral Lichtenstein hernioplasty. Group B were operated by Stoppa repair. Recording of preoperative, operative, and postoperative data was performed for each patient in the study. Patients were assessed postoperatively, and 3, 6, and 12 months after the procedure at the outpatient clinic.

Results: All patients were men. There was no statistically significant difference between both groups in preoperative data. The Stoppa procedure took a significantly shorter time than bilateral Lichtenstein repair; the mean operative time for Stoppa and bilateral Lichtenstein was 78.0 ± 6.40 and 86.80 ± 8.65 min, respectively. Postoperative pain scoring using the visual analogue score at 12 h postoperatively was significantly lower with the use of the Stoppa procedure than bilateral Lichtenstein repair. No significant difference was detected between both groups in operative complications, postoperative complications, hospital stay, return to normal daily activities, and inguinodynia. No recurrence was detected in any of the patients after 1 year of follow-up.

Conclusion: Bilateral inguinal hernias can be repaired simultaneously in the same setting safely and effectively without an increase in morbidity or recurrence rate. The Stoppa procedure can be a good alternative to bilateral Lichtenstein repair for the treatment of bilateral inguinal hernia, with comparable outcome.