Persistent pain after groin hernia surgery: a qualitative analysis of pain and its consequences for quality of life.
BACKGROUND
Despite a high prevalence of persistent groin pain after hernia repair, the specific nature of the pain and its clinical manifestation are poorly known. The aim of this study was to determine the type of post-herniorrhaphy pain and its influence on daily life.


METHODS
In order to assess long-term pain qualitatively and to explore how it affects quality of life, 100 individuals with persisting pain, identified in a cohort study of patients operated for groin hernia, were neurologically examined, along with 100 pain-free controls matched for age, gender and type of operation. The patients were asked to answer the SF-36 questionnaire, the hospital anxiety and depression scale, the Swedish Scales of Personality (SSP) and a standardised questionnaire for assessing everyday life coping. The patients were approached approximately 4.9 years after surgery.


RESULTS
Twenty-two patients from the pain group had become pain free by the time of examination, whereas 76 patients still had pain, of whom 47 (68%) suffered from neuropathic pain and 11 from nociceptive pain. The remaining patients suffered from mixed pain, neuropathic and nociceptive, or were found to have another reason for pain. All dimensions of SF-36 were poorer for the pain group than the control group.


CONCLUSIONS
Persistent post-herniorrhaphy pain is mainly neuropathic and has a substantial impact on health-related quality of life.
Kalliomäki
M-L
ML
Institute of Surgical Sciences, Uppsala University, Uppsala, Sweden. maija-liisa.kalliomaki@surgsci.uu.se
Sandblom
G
G
Gunnarsson
U
U
Gordh
T
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003080:Cold Temperature / Q000009:adverse effects; D005260:Female; D006552:Hernia, Inguinal / Q000601:surgery*; D006358:Hot Temperature / Q000009:adverse effects; D006801:Humans; D006930:Hyperalgesia / Q000453:epidemiology / Q000209:etiology / Q000523:psychology; D006987:Hypesthesia / Q000453:epidemiology / Q000209:etiology / Q000523:psychology; D008297:Male; D008875:Middle Aged; D009437:Neuralgia / Q000453:epidemiology / Q000209:etiology / Q000523:psychology*; D009619:Nociceptors / Q000502:physiology; D010149:Postoperative Pain / Q000453:epidemiology / Q000209:etiology / Q000523:psychology*; D059348:Peripheral Nerve Injuries; D010525:Peripheral Nerves / Q000503:physiopathology; D011788:Quality of Life; D020886:Somatosensory Disorders / Q000453:epidemiology / Q000209:etiology / Q000523:psychology*; D013314:Stress, Mechanical; D011795:Surveys and Questionnaires; D055815:Young Adult