title: Patient satisfaction, chronic pain, and quality of life after elective incisional hernia repair: effects of recurrence and repair technique.
abstract: OBJECTIVE
  To determine the effects of repair technique and hernia recurrence on patient-reported outcomes after incisional hernia repair.
  
  
  METHODS
  This cohort study included patients from sixteen Veteran's Affairs Medical Centers across the United States who underwent elective incisional hernia repair between 1997 and 2002. Technical details and outcomes (repair type and recurrence status) were determined by physician chart review. Patient satisfaction, chronic pain (McGill pain scale and visual analogue scale), and health-related quality of life (Short Form 36) were evaluated with a mailed survey at a median of five years after repair. Multivariable regression modeling was performed to evaluate the effect of repair type and recurrence status on patient-reported outcomes.
  
  
  RESULTS
  Of 854 patients alive at the time of survey mailing, 371 responded (43.4%). Patients with active recurrence were more likely to be dissatisfied with their results (odds ratio (OR) 6.2, P < 0.0001), to have chronic sensory hernia site pain (OR 3.2, P = 0.01), to report disturbance from pain (OR 2.1, P = 0.04), and to have significantly worse quality of life on the Physical Function, General Health, and Physical Component Score domains. Repair technique with permanent mesh versus suture had no independent effect on patient satisfaction, chronic pain, or QOL.
  
  
  CONCLUSIONS
  Recurrence has a substantial negative effect on patient-reported outcomes after incisional hernia repair, whereas the repair technique has no independent effect.
authors.affiliation: Section of Gastrointestinal Surgery, Department of Surgery, University of Alabama at Birmingham, 1922 7th Avenue South, KB 428, Birmingham, AL 35294-0016, USA.
authors.forename: C W
authors.initials: CW
authors.lastname: Snyder
authors.forename: L A
authors.initials: LA
authors.lastname: Graham
authors.forename: C C
authors.initials: CC
authors.lastname: Vick
authors.forename: S H
authors.initials: SH
authors.lastname: Gray
authors.forename: K R
authors.initials: KR
authors.lastname: Finan
authors.forename: M T
authors.initials: MT
authors.lastname: Hawn
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D015331:Cohort Studies; D003625:Data Collection; D017558:Elective Surgical Procedures / Q000379:methods*; D005260:Female; D046449:Hernia, Abdominal / Q000150:complications / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology*; D017060:Patient Satisfaction; D011788:Quality of Life; D012008:Recurrence; D012044:Regression Analysis; D013526:Surgical Mesh; D013537:Sutures