Incidence and management of inguinodynia after inguinal plasty

Abstract

Background: Hernia is defined as a defect of fascial and muscle-aponeurotic structures, allowing the protrusion of elements. The most frequent is inguinal region, prevailing in men 3:1 vs female. The most frequent complications are persistent chronic pain.Methods: A descriptive, prospective and cross-sectional study was performed in postoperative inguinal plasty patients, using a laparoscopic approach and open approach, the presence or absence of inguinodynia was studied using the visual analogue pain scale (VAS) and the Semmes-Weinstein monofilament, in addition to a systematic investigation in the following PubMed, Medline, Clinical Key and Index Medicus databases, with articles from July 2019 to April 2020.Results: Inguinodynia was present in laparoscopic surgery and open approach, 58 patients had inguinodynia at two weeks associated with the inflammatory response of the tissues and the presence of a foreign body (mesh), 77% of the patients with persistence of pain at 3 months reported mild pain (VAS 1-4), 21% moderate pain that did not limit their daily activities (VAS 5-8) and 2% of the patients reported severe pain which limited physical activity and effort (VAS 9-10).Conclusions: Inguinodynia has an impact on hospital costs and quality life, we consider it is essential to domain the anatomical variants of the region. We propose an extensive follow-up of this group of patients, to make a comparison of diagnostic methods, as well as conservative management vs. modern techniques for pain control.

A longitudinal study of the prevalence of post-surgical inguinodynia and the factors responsible for the development of chronic pain among the patients undergoing open hernioplasty at a tertiary care center

“…Out of this, 77% of the patients had persistence mild pain at 3-month post-surgery, 21% had moderate pain and only 2% of the patients reported severe pain which limited physical activity and effort. 13 Majority of the patients experienced mild chronic pain which was consistent with the findings in our study. In another comparative study the authors compared the grading of pain of inguinodynia, postoperative pain duration, the analgesia dosage, duration of hospital-stay, and various complications and came to a conclusion that inguinodynia is significantly lesser in laparoscopy (Trans Abdominal Pre-peritoneal) when compared to open (Lichtenstein) hernioplasty.…”