title: Reoperation for persistent pain after groin hernia surgery: a population-based study.
abstract: OBJECTIVE
  The aim of the present study was to assess the outcome results after reoperation for persistent pain after hernia surgery in a population-based setting.
  
  
  METHODS
  All patients who had undergone surgery for persistent pain after previous groin hernia surgery 1999-2006 were identified in the Swedish Hernia Register (n = 237). Data on the surgical technique used were abstracted from the medical records. The patients were asked to answer a set of questions including SF-36 to evaluate the prevalence of pain after reoperation.
  
  
  RESULTS
  The study group consisted of 95 males and 16 females, mean age 53 years. In 27 % of cases an intervention aimed at suspected ilioinguinal neuralgia was performed. The mesh was removed completely in 28% and partially in 13%. A suture at the pubic tubercle was removed in 13% of cases. Decrease in pain after the most recent reoperation was reported by 69 patients (62%), no change in pain by 21 patients (19%) and increase in pain in 21 patients (19%). There was no significant difference in outcome between mesh removal, removal of sutures at the tubercle or interventions aimed at the ilioinguinal nerve. All subscales of SF-36 were significantly reduced when compared to the age- and gender-matched general population (p < 0.05).
  
  
  CONCLUSIONS
  Patients reoperated for persistent pain after hernia surgery often report a reduction in pain, but the natural course of persistent pain, the relatively low response rate and selection of patients make it difficult to draw definite conclusions.
authors.affiliation: Department of Surgery, Örebro University Hospital, Örebro, Sweden.
authors.forename: N
authors.initials: N
authors.lastname: Magnusson
authors.forename: U
authors.initials: U
authors.lastname: Gunnarsson
authors.forename: P
authors.initials: P
authors.lastname: Nordin
authors.forename: S
authors.initials: S
authors.lastname: Smedberg
authors.forename: M
authors.initials: M
authors.lastname: Hedberg
authors.forename: G
authors.initials: G
authors.lastname: Sandblom
mesh_terms: D059350:Chronic Pain / Q000209:etiology / Q000601:surgery; D005260:Female; D006119:Groin / Q000601:surgery; D006552:Hernia, Inguinal / Q000601:surgery*; D059685:Herniorrhaphy / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009437:Neuralgia / Q000209:etiology / Q000601:surgery*; D010149:Postoperative Pain / Q000209:etiology / Q000601:surgery*; D012086:Reoperation