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Pain after totally extraperitoneal (TEP) hernia repair might fade out within a year

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Abstract

Background

The incidence of chronic pain after endoscopic hernia repair varies between 1 and 16 %. Studies regarding the course of pain in time after the operation are scarce.

Methods

473 male patients ≥18 years of age, scheduled for totally extraperitoneal (TEP) hernia repair (Prolene® mesh) between March 2010 and August 2012 were requested to record pain symptoms preoperative, and 1 day, 1 week, 6 weeks, 3 months and 1 year postoperatively and visit the outpatient department 3 months and 1 year postoperatively for a standardized interview and physical examination.

Results

Preoperatively, 25 % (n = 114) of the patients had moderate-to-severe pain (NRS 4–10). Six weeks postoperatively, 3 % (n = 12) of the patients still experienced moderate-to-severe pain. Three months after TEP, only 3 patients (0.6 %) had moderate-to-severe pain, while 83 patients (18 %) experienced mild pain. One year after TEP, 39 patients experienced mild pain (8 %) and 3 patients moderate pain (0.7 %), no patients experienced severe pain after 1 year. Patients with moderate-to-severe pain preoperatively had a higher risk of pain persisting until 3 months and 1 year postoperatively (p = 0.03). In most patients who had pain 3 months postoperatively and were pain-free 1 year after TEP, pain ‘faded out’ at 4–6 months postoperatively. Two patients had a not-painful recurrent hernia, diagnosed 2 and 5 months after TEP repair.

Conclusion

Moderate-to-severe pain after TEP hernia repair is self-limiting, with less than 1 % of the patients reporting moderate pain 1 year postoperatively.

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Conflict of interest

The authors certify that they have no commercial associations (e.g. consultancies, stock ownership, equity interests, patent-licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article. Partial funding in support of the manuscript was provided in the form of a Research grant from Johnson & Johnson, as is acknowledged in the “Financial Disclosure” attachment.

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Authors and Affiliations

  1. Department of Surgery/Hernia Clinic, Diakonessenhuis Utrecht/Zeist, Room: Secretariaat Heelkunde Professor Lorentzlaan 76, 3707 HL, Zeist, The Netherlands

    J. P. J. Burgmans, N. Schouten, G. J. Clevers, E. J. M. M. Verleisdonk, P. H. P. Davids, C. E. H. Voorbrood & T. Van Dalen

  2. Department of Surgery, UMCU, Utrecht, The Netherlands

    R. K. J. Simmermacher

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  1. J. P. J. Burgmans
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  2. N. Schouten
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  3. G. J. Clevers
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  4. E. J. M. M. Verleisdonk
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  5. P. H. P. Davids
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  6. C. E. H. Voorbrood
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  8. T. Van Dalen
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Correspondence to J. P. J. Burgmans.

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Burgmans, J.P.J., Schouten, N., Clevers, G.J. et al. Pain after totally extraperitoneal (TEP) hernia repair might fade out within a year. Hernia 19, 579–585 (2015). https://doi.org/10.1007/s10029-015-1384-3

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  • DOI: https://doi.org/10.1007/s10029-015-1384-3

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