Surgical treatment of chronic pain after inguinal hernia repair

G. Campanelli, V. Bertocchi, M. Cavalli, G. Bombini, A. Biondi, T. Tentorio, C. Sfeclan, M. Canziani

Research output: Contribution to journalArticle

Abstract

Background: Chronic groin pain is defined as pain arising 3-6 months after inguinal hernia repair that can compromise the patient's quality of life. Many articles in the literature report clinical presentation, but there are no well-defined indications and protocols of treatment. Methods: Forty-six patients underwent surgical treatment for chronic groin pain that consisted of a simultaneous double approach, anterior and posterior, to the inguinal region, with 44 triple neurectomies and 2 iliohypogastric neurectomies. Ilio-inguinal and ilio-hypogastric nerves were resected by anterior approach, while genitofemoral trunk was resected by a posterior pre-peritoneal approach. Mesh was removed in 24 cases, and mesh and plug were removed in 16 cases. A new mesh repair was performed in 42 cases. All the patients were examined 1 week, 1 month and 1 year postoperatively. Results: In 40 patients, the surgical treatment has obtained good response with improvement or complete resolution of the pain. Two patients referred persistent groin pain different from preoperative and in 4 cases the pain persisted without substantial benefit. Mean VAS value was 7.89 before surgery and 1.89 after surgery. Conclusions: Choice of the adequate therapy of chronic groin pain after inguinal hernia repair is still controversial. Our surgical approach turned out to be a safe and effective procedure. In this way, an accurate exploration of the whole inguinal region can be performed along with the identification of the nerves involved. Anyway in a certain number of cases, the resolution of pain cannot be achieved; this suggests a possible involvement of differences in the single personality and tolerances of pain in the different patients.

Original languageEnglish
Pages (from-to)347-353
Number of pages7
JournalHernia
Volume17
Issue number3
DOIs
Publication statusPublished - Jun 2013

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Keywords

  • Chronic groin pain
  • Hernia repair
  • Inguinal pain
  • Postsurgical pain

ASJC Scopus subject areas

  • Surgery

Cite this

Campanelli, G., Bertocchi, V., Cavalli, M., Bombini, G., Biondi, A., Tentorio, T., Sfeclan, C., & Canziani, M. (2013). Surgical treatment of chronic pain after inguinal hernia repair. Hernia, 17(3), 347-353. https://doi.org/10.1007/s10029-013-1059-x