Chronic pain after inguinal hernia repair

ABSTRACT

Hernia repair is one of the most common surgical procedures, and some patients suffer from chronic pain after hernia surgery. Chronic pain was believed to be a recognized but infrequent complication after inguinal hernia repair. Although it is usually mild, its exact cause and lack of evidence-based treatment path present problems in the effective management of this surgical complication. It has significant variable degrees of effects on work and social activities. The aim of the present study was to evaluate chronic post-herniorrhaphy pain in patients who underwent Darn or modified Bassinis' repair. We evaluated the patients over the subsequent 3 months, using a telephone filled questionnaire. The questionnaire included the chronic pain grading scale [CPG] questionnaire to focus on chronic pain and its limitations to their quality of life. The results show that the majority of patients were successfully treated by therapeutic injection into the point of maximal tenderness. It was concluded that chronic pain following open inguinal hernia repair can be disabling, sometimes seriously affecting quality of life. It is, therefore, very important to discuss the possibility of resulting chronic severe pain when obtaining preoperative informed consent. This paper highlights the importance of education of junior trainees about the appropriate issues and skills needed to get informed consent. We believe that each patient must be informed about the possibility of chronic, severe pain and its impact on their quality of life should it occur. The present findings indicate that identification and preservation of nerves during open inguinal hernia repair reduce chronic incapacitating groin pain and that, in the majority of patients with chronic pain at 6 months, the pain at 1 year is resolved only with conservative or medical treatment