Intervention techniques for chronic postherniorrhaphy pain

Abstract

Background: Chronic post-surgical pain is the main problem after inguinal hernia repair, frequently mandating treatment. Different treatment modalities are proposed. The aim of this review was to evaluate recent literature on different interventions to treat chronic inguinal pain after inguinal hernia repair and their outcomes.Methods: The Medline database, CINAHL, Embase, and Pubmed, including e-links to related articles, and the clinical trial registry of the Cochrane Collaboration were searched for relevant articles. Studies since 2001 reporting an intervention and their outcome to treat chronic postoperative inguinal pain in adult patients were selected. Study design, length of follow-up, number of included and evaluated patients, definition of chronic pain, description, as well as outcome of the intervention are extracted.Results: A total of 29 studies were included; eleven of them were prospective, the remaining retrospective. One study about pharmacological treatment (n ¼ 2), two studies about peripheral nerve blockage (n ¼ 9), three studies about pulsed radiofrequency (n ¼ 12), four studies about neurostimulation (n ¼ 7), one study about removal of staples or tackers (n ¼ 1), one study about neuroablation (n ¼ 10), and 17 studies about neurectomy (n ¼ 733) were included.Conclusions: This collective review shows the broad spectrum of interventions to treat chronic postoperative inguinal pain. Due to a wide range of pain definitions and outcome measurement a true comparison is difficult.

Wide Resection of Inguinal Nerves versus Simple Section to Prevent Postoperative Pain after Prosthetic Inguinal Hernioplasty: Our Experience

“…The incidence of chronic groin pain in patients who have undergone inguinal hernioplasty with prosthesis is *10 % (range 0-40). For convention, inguinodynia is defined as chronic if it lasts at least 3 months [1].…”