Hernia : the journal of hernias and abdominal wall surgery
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Pain impairing daily activities following inguinal herniorrhaphy is reported by about 10% of patients, when asked 1-2 years postoperatively. However, the time course and consequences of postherniorrhaphy pain is not known in detail. A nationwide follow-up questionnaire study was undertaken 6.5 years postoperatively in 335 well-described patients reporting pain 1 year after inguinal herniorrhaphy in a previous questionnaire study. ⋯ In the subgroup of patients operated for a recurrence during the observation period and not included in primary analysis, 22 of 44 (50%) still experienced pain at 6.5 years, and 17 (38.6%) reported that pain affected daily activities (mean observation period 4.5 years). Pain after inguinal herniorrhaphy decreased from about 11% 1 year after surgery, but still affects daily activities in about 6% after 6.5 years. Patients operated for a recurrence are at higher risk for persistent pain.
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Herpes zoster affects 10-20% of the general population. Motor complications sometimes occur in the segments corresponding to the involved sensory dermatomes causing abdominal wall pseudohernias. We present a case of a 57-year-old woman with herpes zoster characteristical rash following T11-T12 right dermatomes. ⋯ The bulge totally disappeared after 4 months of observation. Postherpetic pseudohernia must be suspected when a patient develops signs and symptoms of motor dysfunction that coincide with or follow a herpes zoster eruption resulting in abdominal-wall herniation. A review of the literature concerning these extremely exceptional sequelae of herpes zoster is presented.
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Comparative Study
Early results for new lightweight mesh in laparoscopic totally extra-peritoneal inguinal hernia repair.
Prosthetic mesh reinforcement is now routine in the management of inguinal hernia but can cause considerable pain and stiffness around the groin. The aim of this study was to compare the outcome after laparoscopic TEP inguinal repair using new lightweight or traditional heavyweight mesh performed in a single unit. Between November 2004 and March 2005, 113 patients underwent laparoscopic TEP inguinal repair using either lightweight (28 g/m(2)) or heavyweight (85 g/m(2)) mesh. ⋯ Laparoscopic TEP inguinal hernia repair with lightweight mesh yields promising early results. Whilst there was no significant difference in pain or recurrence in the short term, post-operative pain scores improved earlier in patients with lightweight mesh compared to heavyweight mesh. This merits further study, with larger cohorts and longer follow-up, to determine the benefits of lightweight mesh.