Pain and functional impairment 6 years after inguinal herniorrhaphy.
Pain impairing daily activities following inguinal herniorrhaphy is reported by about 10% of patients, when asked 1-2 years postoperatively. However, the time course and consequences of postherniorrhaphy pain is not known in detail. A nationwide follow-up questionnaire study was undertaken 6.5 years postoperatively in 335 well-described patients reporting pain 1 year after inguinal herniorrhaphy in a previous questionnaire study. Three hundred and three patients, who were alive and could be contacted, received a questionnaire 6.5 years after the herniorrhaphy. Response rate was 88%. Of 267 patients responding, 57 were analyzed separately due to subsequent inguinal herniorrhaphy or other major surgery in the observation period, leaving 210 patients (69.3%) for primary analysis. Pain from the previous hernia site was reported by 72 patients (34.3%), and 52 patients (24.8%) reported that pain affected daily activities. Less pain, compared to the 1-year follow-up, was reported by 75.8%, while 16.7% had the same intensity level and 7.5% reported increased pain severity. In the subgroup of patients operated for a recurrence during the observation period and not included in primary analysis, 22 of 44 (50%) still experienced pain at 6.5 years, and 17 (38.6%) reported that pain affected daily activities (mean observation period 4.5 years). Pain after inguinal herniorrhaphy decreased from about 11% 1 year after surgery, but still affects daily activities in about 6% after 6.5 years. Patients operated for a recurrence are at higher risk for persistent pain.
Aasvang
E K
EK
Section of Surgical Pathophysiology, The Juliane Marie Centre, 4074, Rigshospitalet, 2100 Copenhagen, Denmark. eske.aasvang@rh.hosp.dk
Bay-Nielsen
M
M
Kehlet
H
H
D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006552:Hernia, Inguinal / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000503:physiopathology*; D012008:Recurrence; D011795:Surveys and Questionnaires; D013997:Time Factors