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Long-term outcome of surgical treatment of chronic postoperative groin pain: a word of caution

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Abstract

Purpose

Chronic postoperative groin pain is widely accepted to be a serious clinical condition after inguinal hernia repair and Pfannenstiel incision. Surgical treatment has been reported to be effective, but the long-term outcome following these interventions remains unclear. This retrospective study reports the outcome and investigates patient and intra-operative factors to identify possible predictors of success. A literature review of other outcome studies with more than 1 year follow-up is also presented.

Methods

A registry of patients who underwent surgery for chronic postoperative groin pain was analyzed. Pain was assessed using DN4-score and VAS-scale. Primary endpoint was successful pain reduction, as defined by the ratio of VASmax (post/pre) and the subjective outcome (better vs. same-worse).

Results

Fifteen patients underwent surgery for chronic postoperative groin pain between December 2000 and April 2010. Overall, significant pain reduction was achieved in 1/3 of patients. There was no significant association between patient or intra-operative factors and favorable outcome. A complete concordance between subjective outcome and the ratio of VASmax (post/pre) was noted.

Conclusion

The success of surgery for chronic postoperative groin pain is difficult to predict. In this study, one in three patients benefits from an operative treatment. The ratio of VASmax (post/pre) is suggested as a useful pain assessment tool. A further prospective study of sufficient sample size is necessary to identify possible factors associated with favorable outcome after surgery for chronic groin pain.

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Acknowledgments

The authors thank Steffen Fieuws (Leuven Biostatistics and Statistical Bioinformatics Centre, L-BioStat) for appreciated statistical support.

Ethical standard statement

The publication of this study was approved by the Commission of Clinical Ethics of Gasthuisberg University Hospital, Katholieke Universiteit Leuven, Leuven, Belgium.

Conflict of interest

E. V., Y. N. and M. M. declare no conflict of interest.

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Authors and Affiliations

  1. Department of Abdominal Surgery, Gasthuisberg University Hospital, Katholieke Universiteit Leuven, Herestraat 49, 3000, Leuven, Belgium

    E. Valvekens, Y. Nijs & M. Miserez

Authors
  1. E. Valvekens
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  2. Y. Nijs
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  3. M. Miserez
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Correspondence to E. Valvekens.

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Valvekens, E., Nijs, Y. & Miserez, M. Long-term outcome of surgical treatment of chronic postoperative groin pain: a word of caution. Hernia 19, 587–594 (2015). https://doi.org/10.1007/s10029-013-1125-4

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  • DOI: https://doi.org/10.1007/s10029-013-1125-4

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