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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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