Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Jul;34(7):3145-3152.
doi: 10.1007/s00464-019-07082-5. Epub 2019 Aug 28.

Evaluating effectiveness of cognitive behavioral therapy within multimodal treatment for chronic groin pain after inguinal hernia repair

Miles Landry  1   2 , Rachel Lewis  3 , Michael Lew  3 , Brandie Forman  3 , Eric Heidel  3 , Bruce Ramshaw  3
Affiliations

Evaluating effectiveness of cognitive behavioral therapy within multimodal treatment for chronic groin pain after inguinal hernia repair

Miles Landry et al. Surg Endosc. 2020 Jul.

Abstract

Introduction: The development of chronic groin pain after inguinal hernia repair is a complex problem with many potential factors contributing to its development. Surgical options for alleviation of symptoms are limited and only performed by a few centers dedicated to its treatment. Opportunities to apply the principles of a prehabilitation program, including Cognitive Behavioral Therapy (CBT), aim to improve the surgical outcomes for this condition.

Methods and procedures: A multi-disciplinary hernia team has implemented a clinical quality improvement (CQI) effort in an attempt to better measure and improve outcomes for patients suffering with chronic groin pain after inguinal hernia repair. Between April 2011 and August 2018, 129 patients (157 groins) underwent surgical treatment for chronic groin pain after inguinal hernia repair. Data were collected to compare outcomes for those undergoing preoperative CBT and patients who did not have CBT prior to their operation.

Results: Of 129 total patients, baseline demographics were similar in terms of gender, age, and BMI. In total, 27 patients (32 groins) underwent prehabilitation with CBT (20.93%). We found none of the patients who underwent preoperative CBT had new postoperative pain and all patient procedures were able to be performed on an outpatient basis. Overall, 15 (14.7%) patients had no improvement in symptoms after surgery from the non-CBT group, whereas there was improvement in chronic pain for all patients who underwent CBT.

Conclusion: This attempt at process improvement demonstrated beneficial effects for patients who had CBT as part of a prehabilitation program prior to a surgical procedure to attempt to relieve groin pain after inguinal hernia repair. As with any CQI analysis, other factors may have contributed to these outcomes and these results may be different in another local environment.

Keywords: Chronic pain; Clinical quality improvement (CQI); Cognitive behavioral therapy (CBT); Inguinal hernia; Inguinodynia.

PubMed Disclaimer

Similar articles

See all similar articles

Cited by

References

    1. Aasvang E, Kehlet H (2005) Chronic postoperaive pain: the case of inguinal herniorrhaphy. Br J Anaesth 95:69–76 - DOI
    1. Nienhuijs S, Staal E, Strobbe L, Rosman C, Groenewound H, Bleichrodt R (2007) Chronic pain after mesh repair of inguinal hernia: a systematic review. Am J Surg 194(3):394–400 - DOI
    1. Franneby U, Sandblom G, Nordin P, Nyren O, Gunnarsson U (2006) Risk factors for long-term pain after hernia surgery. Ann Surg 244(2):212–219 - DOI
    1. Ferzeli GS, Edwards E, Al-Khoury G, Hardin R (2008) Postherniorrhapy groin pain and how to avoid it. Surg Clin N Am 88:203–209 - DOI
    1. Kehlet H (2008) Chronic pain after groin hernia repair. Br J Surg 95:135–136 - DOI

Publication types

LinkOut - more resources