Classifying post-herniorrhaphy pain syndromes following elective inguinal hernia repair.
BACKGROUND
Chronic post-herniorrhaphy pain is diverse in origin. The aim of our study was to classify post-herniorrhaphy pain syndromes following elective inguinal hernia repair.


METHODS
All patients with an elective inguinal hernia repair performed between January 2000 and August 2005 received a questionnaire evaluating chronic inguinal pain (visual analog scale, VAS 0-10). Patients with moderate to severe pain complaints (VAS score >or= 3) were invited for an interview and an outpatient department physical examination.


RESULTS
A total of 2,164 cases underwent an elective hernia repair and received the questionnaire; 1,766 individuals responded (response rate: 81.6%). Moderate to severe pain was present in 211 patients (11.9%). Follow-up was performed in 148 patients. Three separate groups of diagnoses were identified. Group I: neuropathic pain (n = 72) indicating inguinal nerve damage; group II: non-neuropathic pain (n = 40) due to an array of diagnoses including periostitis (n = 18) and recurrent hernia (n = 13); and group III: a tender spermatic cord and/or a tight feeling in the lower abdomen (n = 43).


CONCLUSIONS
Chronic pain following elective hernia repair is common and diverse in etiology but may allow for a classification contributing to the development of tailored treatment regimens.
Loos
M J A
MJA
Department of Surgery, Máxima Medical Centre, PO Box 7777, De Run, 4600, Veldhoven, The Netherlands. M.Loos@mmc.nl.
Roumen
R M H
RMH
Department of Surgery, Máxima Medical Centre, PO Box 7777, De Run, 4600, Veldhoven, The Netherlands.
Scheltinga
M R M
MRM
Department of Surgery, Máxima Medical Centre, PO Box 7777, De Run, 4600, Veldhoven, The Netherlands.
D000328:Adult; D000368:Aged; D002908:Chronic Disease; D017558:Elective Surgical Procedures / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006552:Hernia, Inguinal / Q000601:surgery*; D006784:Hospitals, Teaching; D006801:Humans; D007264:Inguinal Canal / Q000294:innervation; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000145:classification* / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D013536:Suture Techniques; D016896:Treatment Outcome