Persistent postherniorrhaphy pain following inguinal hernia repair: A cross-sectional study of prevalence, pain characteristics, and effects on quality of life

Ergönenç, Tolga; Beyaz, Serbülent Gökhan; Özocak, Hande; Palabıyık, Onur; Altıntoprak, Fatih

doi:10.1016/j.ijsu.2017.08.588

Cited by 19 publications

(18 citation statements)

References 28 publications

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“…Our results for pain location is also relevant for interpreting reported incidence rates of neuropathic pain that has not been diagnosed by physical examination. Most of our patients with CPSP reported pain in the groin (42%) and/or scar (32%), as in another study [21]. However, some also reported pain at unexpected locations, even ones that bear no apparent relation to the innervation of the surgical field.…”

Section: Discussionsupporting

confidence: 77%

Chronic pain after groin hernia repair: pain characteristics and impact on quality of life

et al. 2020

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Background Chronic postsurgical pain (CPSP) after hernia repair research has mainly relied on unconfirmed self-reporting. We aimed to describe confirmed CPSP incidence, management, and quality of life (QoL) in a 2-year prospective study. Methods Multicenter study (GENDOLCAT) of 3890 patients undergoing 4 common surgical procedures in 23 hospitals to develop a risk model for CPSP; 2352 men underwent open hernia repair. Patients with pain were identified by telephone at 1 and 3 months and referred to the hospital 4 months after surgery for a physical examination to confirm CPSP. Three validated tools were used: the Brief Pain Inventory (BPI) for severity, analgesic use, and interference with activities; the SF-12 questionnaire for QoL (validated Spanish version), and the Douleur Neuropathique 4 (DN4). Patients with CPSP were called again at 1 and 2 years. Results In 1761 patients who underwent hernia repair and were eligible for physical examination for CPSP, the incidence of confirmed pain at 4 months was 13.6% (patient-reported pain, 6.2% at 1 year and 4.0% at 2 years). Neuropathic pain was diagnosed in 38.5% of the CPSP patients at 4 months. The incidences of neuropathic CPSP in patients with mesh or non-mesh repairs were similar (38.6 and 33.3%, respectively). SF-12 physical component scores changed little in all patients, whether or not they developed CPSP. The SF-12 mental component decreased significantly in all patients, but the decrease was clinically significant only in CPSP patients. CPSP interfered with activities (18%), work (15.6%), walking (15%) and mood (10.2%). At 2 years 52.1% of CPSP patients had moderate/intense pain and 28.2% took analgesics. Conclusion CPSP affects QoL-related activities, and although it diminishes over the course of 2 years after surgery, many patients continue to have moderate/intense pain and take analgesics. CPSP and neuropathic pain rates seem to be similar after mesh and non-mesh repair. BPI and SF-12 mental component scores detect effects on QoL. Trial registration ClinicalTrials.gov NCT01510496.

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Section: Discussionsupporting

confidence: 77%

Chronic pain after groin hernia repair: pain characteristics and impact on quality of life

et al. 2020

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“…Although these studies suggest that CSP is a common condition, further studies are needed to confirm the true incidence and prevalence of the condition in the general population. Certain groups of men have a higher incidence of CSP: (1) post-vasectomy pain affects from 1% to 15% of men after their procedures [12,13], (2) an estimated 10% of men with varicocele experience CSP related to that condition [14] and (3) CSP has been reported in as many as 3% to 6% of patients after repair of inguinal hernia [15].…”

Section: Clinical Evaluationmentioning

confidence: 99%

A Review of the Management of Chronic Scrotal Pain

Moubasher

Waqar

Raison

et al. 2020

Cureus

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Chronic scrotal pain (CSP) is a common and poorly understood medical condition that significantly affects individuals’ quality of life. Many patients seek evaluation and management of their symptoms from multiple physicians. Our review aims to address diagnostic modalities, clinical evaluation, and surgical and non-surgical management. We conducted a computerised detailed search of the PubMed, Medline, Embase and Cochrane databases for reports pertaining to CSP using the Medical Subject Headings keywords ‘chronic scrotal pain’, ‘testicular pain’ and ‘orchialgia’, and we included in the review those that fulfilled the inclusion (adult male with CSP presenting with the criteria of CSP ) and exclusion (extra-scrotal pain) criteria. After the direct causes of CSP were identified by reviewing the clinical evaluations (history taking and examination are mandatory) and the diagnostic evaluations (urine analysis is crucial and ultrasound can be helpful), the most-used medical and non-surgical treatments for CSP were tricyclic antidepressants (success rate of up to 66.6%) and spermatic block (success rate of more than 90%), and the most-used surgical procedure was microsurgical denervation of the spermatic cord (success rate of up to 70%). The evidence currently available remains rare and of low quality, making it difficult to strongly recommend individual treatment options. However, multimodal treatment modalities using physical therapy and psychotherapy may help patients and provide useful tools for coping with this condition. There are also useful non-surgical and surgical options for CSP that depend on the patient’s state, the severity of the complaint and what options have already been tried.

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“…Tension‐free hernia repair significantly reduced the number of hernia relapses and, at the same time, changed the structure of postoperative complications (Burger et al, 2004; Hernia Trialists Collaboration, 2000). In particular, some of them are associated with the foreign body reaction: pathological tissue fibrosis, wrinkling of the implant, disrupting the patient's physical activity and leading to hernia recurrences, chronic pain syndrome, implant degradation, and reproductive dysfunction after inguinal hernia repair (Eklund et al, 2010; Ergönenç, Beyaz, Özocak, Palabıyık, & Altıntoprak, 2017; Ott, Groebli, & Schneider, 2005; Seker & Kulacoglu, 2011; Tekatli, Schouten, van Dalen, Burgmans, & Smakman, 2012).…”

Section: Introductionmentioning

confidence: 99%

Computed tomography options in the evaluation of hernia repair outcomes using “titanium silk” mesh implants

Shemyatovsky

Azimov

Alekhin

et al. 2020

J Tissue Eng Regen Med

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Background: According to experimental studies, mesh implants may reduce in size up to 50.8% during their integration into soft tissues. This results in impaired mobility of the anterior abdominal wall and hernia recurrences, as well as affects patients' quality of life. Due to unsatisfactory radiographic contrast of polymeric mesh implants, changes in their size can be rarely confirmed using imaging methods. Medical devices made of metal alloys have the best radiographic contrast. Objective: The purpose of this study was to evaluate the radiographic contrast of mesh implants made of titanium filaments and to determine the sizes and locations of the implants after the anterior abdominal wall hernia repair. Materials & Methods: The study included 40 patients with inguinal, umbilical, and postoperative ventral hernias. Surgical hernia repair was performed using a mash implant made of titanium filaments, "titanium silk". Multislice spiral computed tomography (MSCT) was performed on Days 3 and 90 after surgery, followed by an assessment of the size and location of the mesh implant.Results: 90 days after the anterior abdominal wall hernia repair, the locations of the titanium silk mesh implants in the tissues corresponded to their intraoperative setting. There were no statistically significant changes in the sizes of mesh implants on Day 90, compared with Day 3. Conclusion:The titanium silk mesh implants have satisfactory radiographic contrast, which allows imaging of their location and size in the tissues using MSCT and comprehensive evaluation of hernia repair outcomes using instrumental methods of examination. K E Y W O R D S3D reconstruction, multislice spiral computed tomography, polymeric mesh implants, radiographic contrast, soft tissues, titanium mesh

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Persistent postherniorrhaphy pain following inguinal hernia repair: A cross-sectional study of prevalence, pain characteristics, and effects on quality of life

Cited by 19 publications

References 28 publications

Chronic pain after groin hernia repair: pain characteristics and impact on quality of life

Chronic pain after groin hernia repair: pain characteristics and impact on quality of life

A Review of the Management of Chronic Scrotal Pain

Computed tomography options in the evaluation of hernia repair outcomes using “titanium silk” mesh implants

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