A Novel One-Stop Multidisciplinary Clinic for Chronic Postoperative Inguinal Pain: Initial Experiences and Outcomes
- PMID: 40589462
- PMCID: PMC12206668
- DOI: 10.3389/jaws.2025.14317
A Novel One-Stop Multidisciplinary Clinic for Chronic Postoperative Inguinal Pain: Initial Experiences and Outcomes
Abstract
Background: Chronic Postoperative Inguinal Pain (CPIP) affects 10%-20% of patients following inguinal hernia repair, persisting for over 3 months post-surgery. It involves a complex interplay of neuropathic and nociceptive pain, secondary sensitization, and functional and psychological impacts. The condition often coexists with other pain causes, complicating diagnosis and treatment. Despite recommendations for multidisciplinary management, diagnostic and treatment pathways are frequently fragmented.
Objective: This study evaluated the efficacy of a one-stop multidisciplinary clinic for CPIP in improving patient-reported outcomes (PROMS) and satisfaction.
Methods: A one-stop multidisciplinary clinic was established at the North Devon Comprehensive Hernia Centre, involving an Abdominal Wall Surgeon, Advanced Clinical Practitioners, Pain Management Consultants, and Pain Specialist Physiotherapists. Following a remote ACP assessment, patients underwent 45-minute evaluations by a surgeon, pain specialist, and physiotherapist, culminating in an MDT discussion and a personalized management plan. Data were retrospectively collected for patients reviewed between July 2021 and July 2022, including demographics, surgical history, CPIP diagnoses, treatments, and PROMS.
Results: Forty patients underwent MDT assessment; 55% pursued further treatment. Among 19 patients with follow-up data, 26% underwent surgery, 35% invasive non-surgical treatments, and 39% pharmacological therapies combined with physiotherapy and psychological support. Pain scores (VAS) decreased from 7.2 to 2.8, and functional activity (mAAS) improved from 20.3 to 9.7 (p < 0.0001). Patient satisfaction was high (mean score: 4.5/5).
Conclusion: The one-stop multidisciplinary clinic significantly improved pain, function, and satisfaction, highlighting its value for CPIP management. Larger studies with delayed follow-up are needed to validate these findings.
Keywords: chronic postoperative inguinal pain (CPIP); hernia surgery complications; multidisciplinary clinic; pain management; patient-reported outcomes (PROMS).
Copyright © 2025 Cocciolo, Birch, Pawlak, Miller, Bennett, Lund, Sanders and Findlay.
Conflict of interest statement
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Figures
Similar articles
-
Mesh versus non-mesh for inguinal and femoral hernia repair.Cochrane Database Syst Rev. 2018 Sep 13;9(9):CD011517. doi: 10.1002/14651858.CD011517.pub2. Cochrane Database Syst Rev. 2018. PMID: 30209805 Free PMC article.
-
Uniformity of Chronic Pain Assessment after Inguinal Hernia Repair: A Critical Review of the Literature.Eur Surg Res. 2017;58(1-2):1-19. doi: 10.1159/000448706. Epub 2016 Aug 27. Eur Surg Res. 2017. PMID: 27577699 Free PMC article.
-
Laparoscopic surgery for inguinal hernia repair: systematic review of effectiveness and economic evaluation.Health Technol Assess. 2005 Apr;9(14):1-203, iii-iv. doi: 10.3310/hta9140. Health Technol Assess. 2005. PMID: 15842951
-
Topical capsaicin (high concentration) for chronic neuropathic pain in adults.Cochrane Database Syst Rev. 2017 Jan 13;1(1):CD007393. doi: 10.1002/14651858.CD007393.pub4. Cochrane Database Syst Rev. 2017. PMID: 28085183 Free PMC article.
-
Antidepressants for pain management in adults with chronic pain: a network meta-analysis.Health Technol Assess. 2024 Oct;28(62):1-155. doi: 10.3310/MKRT2948. Health Technol Assess. 2024. PMID: 39367772 Free PMC article.
Cited by
-
Chronic postoperative inguinal pain: prevention is better than 'cure'.Front Surg. 2025 Jul 23;12:1632219. doi: 10.3389/fsurg.2025.1632219. eCollection 2025. Front Surg. 2025. PMID: 40772256 Free PMC article. No abstract available.
References
LinkOut - more resources
Full Text Sources