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Female gender is a risk factor for pain, discomfort, and fatigue after laparoscopic groin hernia repair

A Comment to this article was published on 21 May 2013



Female gender is a risk factor for early pain after several specific surgical procedures but has not been studied in detail after laparoscopic groin hernia repair. The aim of this study was to compare early postoperative pain, discomfort, fatigue, and nausea and vomiting between genders undergoing laparoscopic groin hernia repair.


Prospective consecutive enrollment of women and age-matched (±1 year) and uni-/bilateral hernia-matched male patients undergoing elective transabdominal preperitoneal hernia repair (TAPP). Patients in the two groups received a similar anesthetic, surgical, and analgesic treatment protocol.


Between August 2009 and August 2010, 25 women and 25 men undergoing elective TAPP were prospectively included in the analysis (n = 50) with no significant difference between groups in psychological status regarding anxiety, depression, and catastrophizing. On day 0, women had significantly more pain during rest (p = 0.015) and coughing (p = 0.012), discomfort (p = 0.001), and fatigue (0.020) compared with men. Additionally, cumulative overall postoperative pain during coughing, discomfort, and fatigue on day 0–3 was significantly higher in women compared with men (all p values < 0.05). Women required significantly more opioids (p = 0.015) and had a significantly higher incidence of vomiting on days 0 and 1 (p = 0.002).


Women experienced more pain, discomfort, and fatigue compared with men after laparoscopic groin hernia repair.

Trial registration

Registration number NCT00962338 (

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Corresponding author

Correspondence to M. A. Tolver.

Additional information

Trial Funding: Region Zealand′s Health Research Fund (RESUS) and Department of Surgery, Køge Hospital.

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Tolver, M.A., Strandfelt, P., Rosenberg, J. et al. Female gender is a risk factor for pain, discomfort, and fatigue after laparoscopic groin hernia repair. Hernia 17, 321–327 (2013).

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  • Laparoscopic inguinal hernia repair
  • TAPP
  • Pain
  • Sex
  • Women
  • Men