Chronic Pain After Hernia Surgery: Risk Factors Identified

What factors increase the risk for inguinodynia after open mesh repair?

Although the advent of open inguinal hernia mesh repair has decreased recurrence rates, chronic pain — also known as inguinodynia — is emerging as a significant adverse effect of the procedure.

In an effort to identify potential predictors of inguinodynia, researchers led by Georgios A Pierides, MD, from Helsinki University Hospital in Finland, analyzed data from 932 open mesh procedures.

Their findings, published in the April issue of the International Journal of Surgery, showed that the most important factors were hernia recurrence, other complications, mesh weight, and pain level before surgery.

Prior studies have identified recurrent hernia, high pain scores in the weeks after surgery, younger age, and female gender as risk factors for inguinodynia. Factors associated with decreased risk have included laparoscopic repair, lighter weight mesh, and older age.1,2

“Chronic pain after hernia surgery with mesh repair has been well documented for many years but is underappreciated by surgeons and primary care [physicians] and underreported,” Bipan Chand, MD, told Clinical Pain Advisor.

Dr Chand, who was not involved in the study, is an associate professor of surgery and division director of gastrointestinal and minimally invasive surgery at Loyola University Medical Center in Maywood, Illinois.