Prospective study evaluating the impact of severity of chronic pain on quality of life after inguinal hernioplasty

Nikkolo, Ceith; Kirsimägi, Ülle; Vaasna, T.; Murruste, Marko; Suumann, Jaanus; Seepter, H.; Lepner, Urmas

doi:10.1007/s10029-016-1569-4

Cited by 7 publications

(2 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Persistent severe pain occurring in the aftermath of a surgical procedure is frequently associated with significant impairment of physical and psycho-social functions. [1][2][3][4] After groin hernia repair (GHR), 2-4% of patients develop persistent severe pain. The GHR procedure, previously considered belonging to "minor" surgeries, qualifies as a rather complex procedure performed in a territory with a high density of nerve fibers, accommodating essential functions for locomotion and reproduction.…”

Section: Introductionmentioning

confidence: 99%

Somatosensory Outcomes Following Re-Surgery in Persistent Severe Pain After Groin Hernia Repair: A Prospective Observational Study

Jensen¹,

Ringsted²,

Bischoff³

et al. 2023

JPR

View full text Add to dashboard Cite

Purpose After groin hernia repair (globally more than 20 million/year) 2–4% will develop persistent severe pain (PSPG). Pain management is challenging and may require multimodal interventions, including re-surgery. Quantitative somatosensory testing (QST) is an investigational psychophysiological tool with the potential to uncover the pathophysiological mechanisms behind the pain, ie, revealing neuropathic or inflammatory components. The primary objective was to examine and describe the underlying pathophysiological changes in the groin areas by QST before and after re-surgery with mesh removal and selective neurectomy. Patients and Methods Sixty patients with PSPG scheduled for re-surgery and with an inflammatory “component” indicated by blunt pressure algometry were examined in median (95% CI) 7.9 (5.8–11.5) months before and 4.0 (3.5–4.6) months after re-surgery. The QST-analyses included standardized assessments of cutaneous mechanical/thermal detection and pain thresholds. Suprathreshold heat stimuli were applied. Deep tissue sensitivity was tested by pressure algometry. Testing sites were the groin areas and the lower arm. Before/after QST data were z-transformed. Results Re-surgery resulted in median changes in rest, average, and maximal pain intensity scores of −2.0, −2.5, and −2.0 NRS (0/10) units, respectively ( P = 0.0001), and proportional increases in various standardized functional scores ( P = 0.0001). Compared with the control sites, the cutaneous somatosensory detection thresholds of the painful groin were increased before re-surgery and increased further after re-surgery (median difference: 1.28 z-values; P = 0.001), indicating a successive post-surgical loss of nerve fiber function (“deafferentation”). Pressure algometry thresholds increased after re-surgery (median difference: 0.30 z-values; P = 0.001). Conclusion In this subset of patients with PSPG who underwent re-surgery, the procedure was associated with improved pain and functional outcomes. While the increase in somatosensory detection thresholds mirrors the surgery-induced cutaneous deafferentation, the increase in pressure algometry thresholds mirrors the removal of the deep “pain generator”. The QST-analyses are useful adjuncts in mechanism-based somatosensory research.

show abstract

Section: Introductionmentioning

confidence: 99%

Somatosensory Outcomes Following Re-Surgery in Persistent Severe Pain After Groin Hernia Repair: A Prospective Observational Study

Jensen¹,

Ringsted²,

Bischoff³

et al. 2023

JPR

View full text Add to dashboard Cite

show abstract

“…Severe persistent postsurgical pain (PPP) after groin hernia repair causes psychophysical disability and impairs quality-of-life for a considerable number of individuals each year. [1,2,3] In the USA 600,000 groin hernia repairs (GHR) are performed annually, and a conservative estimate is that 2%, corresponding to 12,000 individuals, each year will develop this debilitating pain condition. [4,5] The management of PPP often requires multidisciplinary efforts.…”

Section: Introductionmentioning

confidence: 99%

A national center for persistent severe pain after groin hernia repair

et al. 2019

View full text Add to dashboard Cite

show abstract

Decreasing prevalence of chronic pain after laparoscopic groin hernia repair: a nationwide cross-sectional questionnaire study

2018

View full text Add to dashboard Cite

show abstract

Prospective study evaluating the impact of severity of chronic pain on quality of life after inguinal hernioplasty

Abstract: Pain scores 20 mm or less on the VAS (0 to 100 mm) have no impact on the patients' quality of life. Uniform assessment methods of chronic pain should be developed to improve the quality of research.

Cited by 7 publications

References 17 publications

Somatosensory Outcomes Following Re-Surgery in Persistent Severe Pain After Groin Hernia Repair: A Prospective Observational Study

Somatosensory Outcomes Following Re-Surgery in Persistent Severe Pain After Groin Hernia Repair: A Prospective Observational Study

A national center for persistent severe pain after groin hernia repair

Decreasing prevalence of chronic pain after laparoscopic groin hernia repair: a nationwide cross-sectional questionnaire study

Contact Info

Product

Resources

About