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Surgery for chronic inguinodynia following routine herniorrhaphy: beneficial effects on dysejaculation

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Abstract

Purpose

Pain during sexual activities and ejaculation is reported by 3–4 % of men after routine inguinal herniorrhaphy. The potential beneficial effects of surgery for chronic groin pain on dysejaculation are unknown. The objective of this study was to determine dysejaculation rates in a series of patients reporting chronic postherniorrhaphy pain and evaluate the effects of tailored neurectomy on dysejaculation.

Methods

We evaluated male patients (>18 years) operated for chronic groin pain after inguinal herniorrhaphy during a 6-year time period (2004–2010). Dysejaculation was defined as a burning or searing sensation associated with ejaculation. Men reporting symptoms possibly associated with dysejaculation were sent a questionnaire investigating pain characteristics (VAS, 0–100), influence on sex life and effects of the tailored neurectomy. A Post-Herniorrhaphy Dysejaculation Score (PHDS, 0–12 points) was introduced to quantify the severity of the dysejaculation syndrome.

Results

A series of 100 males operated for chronic inguinal pain after standard herniorrhaphy were studied. Thirty-four men reported symptoms of dysejaculation prior to the tailored neurectomy. Sex life was negatively influenced in 20 of these, and 5 completely abstained from any sexual activity. Following surgery including tailored neurectomy, funicular release and/or mesh removal, VAS for dysejaculation pain was significantly reduced [n = 20, 55 (95 % CI 47–63) versus 21 (95 % CI 13–29), p < 0.001]. PHDS scores were also significantly attenuated [n = 20, 10 (3–12) versus 2 (0–10), p < 0.001]. Sex life normalized in two-thirds of these men (13/20).

Conclusion

Dysejaculation in men suffering from chronic pain after routine inguinal herniorrhaphy is not uncommon. A tailored neurectomy, funicular release and/or mesh removal offer relief in the majority of these patients.

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Correspondence to T. Verhagen.

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Conflict of interest

TV declares no conflict of interest. ML declares no conflict of interest. MS declares no conflict of interest and RR declares no conflict of interest.

Appendix: Post-herniorrhaphy Dysejaculation Score (PHDS)

Appendix: Post-herniorrhaphy Dysejaculation Score (PHDS)

Please indicate..

 

(Points)

..the intensity of pain during or after ejaculation

A. No pain at all

(0)

B. Mild

(1)

C. Moderate

(2)

D. Severe

(3)

E. Very severe

(4)

..the frequency of pain during or after ejaculation

A. Never any pain

(0)

B. Pain between 0% and 50% of the time

(1)

C. Between 50% and 75% of the time

(2)

D. Between 75% and 100% of the time

(3)

E. Always

(4)

..the impact of pain during or after ejaculation on your sexual activities

A. No impact on my sexual activities

(0)

B. The pain affects my sex life but does not cause me to abstain from sexual activity

(2)

C. The pain causes me to abstain from any sexual activity

(4)

Total Score (range 0–12)

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Verhagen, T., Loos, M.J.A., Scheltinga, M.R.M. et al. Surgery for chronic inguinodynia following routine herniorrhaphy: beneficial effects on dysejaculation. Hernia 20, 63–68 (2016). https://doi.org/10.1007/s10029-015-1410-5

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  • DOI: https://doi.org/10.1007/s10029-015-1410-5

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