Hernia : the journal of hernias and abdominal wall surgery
-
The incidence of chronic pain after Kugel herniorrhaphy is not well documented, since it was not used as a primary outcome measure in studies reporting on the Kugel technique. The aim of the present study was to report on the incidence and severity of chronic pain 1 year after Kugel herniorrhaphy and to identify the risk factors associated with the development of chronic pain. ⋯ The Kugel inguinal hernia repair is associated with a low rate of postoperative chronic pain. The minimally invasive preperitoneal approach of the Kugel technique probably causes less nerve damage and subsequent neuropathic pain. Chronic pain seems to be more common in young female patients with immediate postoperative pain.
-
In groin hernia repair studies, chronic pain is a frequently used primary endpoint. However, its impact on daily life activities has been less investigated. Such an outcome is relevant for the patient and surgeon and cannot be extrapolated out of pain scores. The Pain Disability Index (PDI), a questionnaire wherein patients rate their impairment, could reveal the consequences of pain. The PDI was therefore introduced in a trial upon open mesh-based inguinal hernia repair. ⋯ The PDI is feasible in inguinal hernia repair and can be used as an adjuvant in pain measurement. It can identify patients still suffering postoperatively who might otherwise be missed. Furthermore, the PDI could serve as a predictor for chronic pain.
-
There is little information available on recurrence rates following primary open inguinal hernia repair in women. Women are less prone to inguinal hernias than men; for the same reason, recurrences after hernia repair may also be lower so that the well-known advantage of using mesh could be lost on them. ⋯ The routine use of mesh for open indirect inguinal hernia repair in women may not be necessary.
-
In Edinburgh a group of surgeons agreed to convert to a lightweight, composite mesh (Ultrapro-Ethicon) for totally extraperitoneal (TEP) inguinal hernia surgery. The aim of this study was to compare the outcome following the use of a new lightweight vs a standard heavyweight mesh during TEP hernia repair. ⋯ In view of increased patient comfort, we continue to recommend LWM for laparoscopic inguinal hernia surgery but would recommend that, in larger hernias and possibly for all, the surgeon should improve mesh adhesion.
-
Aim of this study was to analyze long-term sequelae, risk factors, and satisfaction after inguinal hernia primary repair. ⋯ This study demonstrates that the main problem after inguinal hernia repair remains chronic pain, which was the primary reason of dissatisfaction. The SF-MPQ is feasible and easy to administer to all patients and provides important information about qualitative features of the pain.