title: Pain after totally extraperitoneal (TEP) hernia repair might fade out within a year.
abstract: BACKGROUND
  The incidence of chronic pain after endoscopic hernia repair varies between 1 and 16 %. Studies regarding the course of pain in time after the operation are scarce.
  
  
  METHODS
  473 male patients ≥18 years of age, scheduled for totally extraperitoneal (TEP) hernia repair (Prolene® mesh) between March 2010 and August 2012 were requested to record pain symptoms preoperative, and 1 day, 1 week, 6 weeks, 3 months and 1 year postoperatively and visit the outpatient department 3 months and 1 year postoperatively for a standardized interview and physical examination.
  
  
  RESULTS
  Preoperatively, 25 % (n = 114) of the patients had moderate-to-severe pain (NRS 4-10). Six weeks postoperatively, 3 % (n = 12) of the patients still experienced moderate-to-severe pain. Three months after TEP, only 3 patients (0.6 %) had moderate-to-severe pain, while 83 patients (18 %) experienced mild pain. One year after TEP, 39 patients experienced mild pain (8 %) and 3 patients moderate pain (0.7 %), no patients experienced severe pain after 1 year. Patients with moderate-to-severe pain preoperatively had a higher risk of pain persisting until 3 months and 1 year postoperatively (p = 0.03). In most patients who had pain 3 months postoperatively and were pain-free 1 year after TEP, pain 'faded out' at 4-6 months postoperatively. Two patients had a not-painful recurrent hernia, diagnosed 2 and 5 months after TEP repair.
  
  
  CONCLUSIONS
  Moderate-to-severe pain after TEP hernia repair is self-limiting, with less than 1 % of the patients reporting moderate pain 1 year postoperatively.
authors.affiliation: Department of Surgery/Hernia Clinic, Diakonessenhuis Utrecht/Zeist, Room: Secretariaat Heelkunde Professor Lorentzlaan 76, 3707 HL, Zeist, The Netherlands, iburgmans@diakhuis.nl.
authors.forename: J P J
authors.initials: JP
authors.lastname: Burgmans
authors.forename: N
authors.initials: N
authors.lastname: Schouten
authors.forename: G J
authors.initials: GJ
authors.lastname: Clevers
authors.forename: E J M M
authors.initials: EJ
authors.lastname: Verleisdonk
authors.forename: P H P
authors.initials: PH
authors.lastname: Davids
authors.forename: C E H
authors.initials: CE
authors.lastname: Voorbrood
authors.forename: R K J
authors.initials: RK
authors.lastname: Simmermacher
authors.forename: T
authors.initials: T
authors.lastname: Van Dalen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D059350:Chronic Pain / Q000209:etiology; D004724:Endoscopy; D006552:Hernia, Inguinal / Q000601:surgery*; D059685:Herniorrhaphy / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000209:etiology*; D011446:Prospective Studies; D012075:Remission, Spontaneous; D013526:Surgical Mesh / Q000009:adverse effects; D011795:Surveys and Questionnaires; D013997:Time Factors; D055815:Young Adult