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Gender differences in epigastric hernia repair: a propensity score matching analysis of 15,925 patients from the Herniamed registry

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Abstract

Introduction

In recent surgical literature, gender-specific differences in the outcome of hernia surgery has been analyzed. We already know that female patients are at higher risk to develop chronic postoperative pain after inguinal, incisional, and umbilical hernia surgery. In this study, we evaluated the impact of gender on the outcome after epigastric hernia surgery.

Methods

A covariable-adjusted matched-paired analysis with data derived from the Herniamed registry was performed. In total of 15,925 patients with 1-year follow-up data were included in the study. Propensity score matching was performed for the 7786 female (48.9%) and 8139 male (51.1%) patients, creating 6350 pairs (81.6%).

Results

Matched-paired analysis revealed a significant disadvantage for female patients for pain on exertion (12.1% vs. 7.6%; p < 0.001) compared to male patients. The same effect was demonstrated for pain at rest (6.2% in female patients vs. 4.1% in male patients; p < 0.001) and pain requiring treatment (4.6% in female patients vs. 3.1% in male patients; p < 0.001). All other outcome parameters showed no significant differences between female and male patients.

Conclusions

Female patients are at a higher risk for chronic pain after elective epigastric hernia repairs compared to the male patient population. These results complete findings of previous studies showing the same effect in inguinal, umbilical, and incisional hernia repair.

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Data availability

The data that support the findings of this study are available from the corresponding author (HH) upon reasonable request.

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Funding

Dr. Köckerling has grants to fund Herniamed from Johnson & Johnson, Norderstedt, Karl Storz, Tuttlingen, pfm medical, Cologne, Dahlhausen, Cologne, B Braun, Tuttlingen, Men- keMed, Munich, Bard, Karlsruhe. Personal fees from Bard, Karlsruhe, outside the submitted work. All other authors have nothing to disclose.

Author information

Authors and Affiliations

  1. Center for Hernia Surgery and Proctology, ZweiChirurgen GmbH, St. Johanns Vorstadt 44, 4056, Basel, Switzerland

    H. Hoffmann, D. Nowakowski & P. Kirchhoff

  2. Clinic for Orthopedics and Surgery, Merian Iselin Clinic, Basel, Switzerland

    H. Hoffmann, D. Nowakowski & P. Kirchhoff

  3. Breast and Endocrine Surgery, St. George Hospital, Kogarah, NSW, 2217, Australia

    R. Mechera

  4. StatConsult, Magdeburg, Germany

    D. Adolf

  5. Center for Hernia Surgery, Vivantes Humboldt Clinic, Berlin, Germany

    H. Riediger & F. Köckerling

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  1. H. Hoffmann
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  2. R. Mechera
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  3. D. Nowakowski
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  4. D. Adolf
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  5. P. Kirchhoff
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  7. F. Köckerling
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Corresponding author

Correspondence to H. Hoffmann.

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Conflict of interest

Dr. Köckerling reports grants to fund Herniamed from Johnson & Johnson, Norderstedt, Karl Storz, Tuttlingen, pfm medical, Cologne, Dahlhausen, Cologne, B.Braun, Tuttlingen, MenkeMed, Munich, and personal fees from Bard-B, Karlsruhe. All other authors have nothing to disclose.

Ethical approval

Only cases of routine hernia surgery were documented in the Herniamed Registry and all patients have signed a special informed consent declaration agreeing to participate. The Herniamed Registry has ethical approval (BASEC Nr 2016–00,123, 287/2017BO2).

Human and animal rights

This article does not contain any study with animals performed by any of the authors.

Informed consent

All patients with routine hernia surgery documented in the Herniamed Registry have signed an informed consent declaration agreeing to participate.

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Hoffmann, H., Mechera, R., Nowakowski, D. et al. Gender differences in epigastric hernia repair: a propensity score matching analysis of 15,925 patients from the Herniamed registry. Hernia 27, 829–838 (2023). https://doi.org/10.1007/s10029-023-02799-8

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