Chronic pain following a Lichtenstein inguinal hernia repair: a clinical and legal dilemma.
BACKGROUND
Chronic pain following a Lichtenstein inguinal hernia is frequent and raises major concerns regarding informed consent recall.


OBJECTIVE
To assess the frequency of chronic pain and associated factors following inguinal hernia repair in a district general hospital. To assess patient recall of the consent process as it pertains to chronic pain.


METHODS
A random sample (170/293 patients) of those who underwent a Lichtenstein inguinal hernia repair between 2002 and 2004 were retrospectively assessed for the frequency, intensity and other co-factors of chronic pain. They were also questioned about their recollection of the consent process and information given regarding chronic pain.


RESULTS
50 percent of patients reported chronic pain at a median follow-up of 62 months with 30% reporting a significant impact on daily activities. Younger age, the absence of a lump at presentation, pre-operative pain and elective repair were the only factors significantly shown to increase the likelihood of post-operative pain. Patients with post-operative pain were significantly more likely to report that they had not been informed of the possibility of chronic pain pre-operatively or at the time of consent. Twenty percent of these patients stated that they would not have undergone the operation if they had been informed of the possibility of chronic pain.


CONCLUSIONS
Chronic pain is frequent and debilitating. Documentation of chronic pain as a possible outcome at the time of consent should be mandatory as patient recall is poor.
Paily
Abhilash
A
Wishaw General Hospital, NHS Scotland, Wishaw ML2 0DP, UK.
Thornton
Michelle
M
D002908:Chronic Disease; D005260:Female; D006552:Hernia, Inguinal / Q000601:surgery*; D006769:Hospitals, General; D006801:Humans; D007258:Informed Consent; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000453:epidemiology*; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D006113:United Kingdom / Q000453:epidemiology