title: Chronic Inguinal Pain After Kidney Transplantation, a Common and Underexposed Problem.
abstract: The incidence and impact of chronic inguinal pain after kidney transplantation is not clearly established. A high incidence of pain after inguinal hernia repair, a comparable surgical procedure, suggests an underexposed problem.
  
  
  
  Between 2011 and 2013, 403 consecutive patients who underwent kidney transplantation were invited to complete the Caroline Comfort Scale (CCS) and Visual Analog Scale (VAS) in order to assess the incidence of chronic inguinal pain and movement disabilities, complemented by questions regarding comorbidity during follow-up.
  
  
  
  The response rate was 58 % (n = 199) with a median follow-up of 22 months (IQR 12-30). In total, 90 patients (45 %) reported a CCS > 0 and 64 patients (32 %) experienced at least mild but bothersome complaints. Most inguinal complaints were reported during bending over and walking with a mean CCS score of 1.1 (SD ± 2.2) and 1.2 (SD ± 2.4), respectively. A high body mass index (BMI), delayed graft function, and the need for a second operation were associated with a higher CCS score on univariate analysis. Using multivariate analysis, only BMI (p = 0.02) was considered an independent risk factor for chronic inguinal pain.
  
  
  
  The incidence of chronic inguinal pain is a common though underexposed complication after kidney transplantation. More awareness to prevent neuropathic pain seems indicated.
authors.affiliation: Department of Surgery, Division of Transplant Surgery, University Medical Center Groningen, University of Groningen, P.O. Box 30 001, 9700 RB, Groningen, The Netherlands.
authors.forename: Marcel
authors.initials: M
authors.lastname: Zorgdrager
authors.affiliation: Department of Surgery, Division of Transplant Surgery, University Medical Center Groningen, University of Groningen, P.O. Box 30 001, 9700 RB, Groningen, The Netherlands.
authors.forename: Johan F M
authors.initials: JF
authors.lastname: Lange
authors.affiliation: Department of Surgery, Division of Transplant Surgery, University Medical Center Groningen, University of Groningen, P.O. Box 30 001, 9700 RB, Groningen, The Netherlands.
authors.forename: Christina
authors.initials: C
authors.lastname: Krikke
authors.affiliation: Department of Anesthesiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Gertrude J
authors.initials: GJ
authors.lastname: Nieuwenhuijs
authors.affiliation: Department of Surgery, Division of Transplant Surgery, University Medical Center Groningen, University of Groningen, P.O. Box 30 001, 9700 RB, Groningen, The Netherlands.
authors.forename: Sybrand H
authors.initials: SH
authors.lastname: Hofker
authors.affiliation: Department of Surgery, Division of Transplant Surgery, University Medical Center Groningen, University of Groningen, P.O. Box 30 001, 9700 RB, Groningen, The Netherlands.
authors.forename: Henri G D
authors.initials: HG
authors.lastname: Leuvenink
authors.affiliation: Department of Surgery, Division of Transplant Surgery, University Medical Center Groningen, University of Groningen, P.O. Box 30 001, 9700 RB, Groningen, The Netherlands. pol.chirurgie@gmail.com.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Pol
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D059350:Chronic Pain / Q000209:etiology*; D051799:Delayed Graft Function / Q000150:complications; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007264:Inguinal Canal; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000209:etiology*; D012086:Reoperation / Q000009:adverse effects; D012307:Risk Factors; D011795:Surveys and Questionnaires