Chronic pain after open mesh and sutured repair of indirect inguinal hernia in young males

Abstract

Background: Chronic pain is common after herniorrhaphy, but the effect of surgical technique (mesh versus non-mesh repair) and the social consequences of the pain have not been established. The aim of this study was to analyse chronic postherniorrhaphy pain and its social consequences in young males operated on for an indirect inguinal hernia with a Lichtenstein mesh repair, Shouldice or Marcy (annulorrhaphy) repair.

Methods: This was a postal questionnaire study carried out within the Danish and Swedish Hernia Database Collaboration. Some 2612 patients responded (response rate 80.9 per cent), of whom 1250 had undergone a Lichtenstein, 630 a Shouldice and 732 a Marcy repair.

Results: Chronic pain had been experienced within the previous month by 22.9 per cent of the patients who responded. There was an overall decrease in pain with time, from 29.7 per cent at 6-12 months to 18.1 per cent at 37-48 months after surgery, with no overall differences between the three types of repair. Pain was more common in patients younger than 40 years of age. Some 3.9 per cent of patients described the pain as moderate to severe and as frequent or constant. Of all patients with pain, 10.7 per cent experienced it as worse after than before surgery, and 56.6 per cent stated that it interfered with social activities.

Conclusion: Chronic pain is common after primary inguinal hernia repair in young males, but there is no difference in the pain associated with open mesh and non-mesh repair.