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Dysejaculation after laparoscopic inguinal herniorrhaphy: a nationwide questionnaire study

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Abstract

Background

Dysejaculation and pain from the groin and genitals during sexual activity represent a clinically significant problem in up to 4% of younger males after open inguinal herniorrhaphy. The aim of this questionnaire study is to assess the prevalence of dysejaculation and pain during sexual activity after laparoscopic inguinal herniorrhaphy on a nationwide basis.

Methods

The study population comprised all men aged 18–50 years registered in the Danish Hernia Database (n = 1,671) who underwent primary laparoscopic herniorrhaphy between January 1, 1998 and November 30, 2009. Questionnaires regarding dysejaculation and pain during sexual activity were mailed 3 months to 12 years after surgery, and 1,172 patients were included for analysis.

Results

The response rate was 68.7% (n = 805). Dysejaculation occurring after laparoscopic repair was present in 25 patients (3.1%). Pain from the groin or genitals during sexual activity was reported by 88 patients (10.9%), and 19 patients (2.4%) reported that the pain had impaired their sexual activity to a moderate or severe degree. Older patients and patients with longer follow-up had lower prevalence of pain during sexual activity.

Conclusions

Dysejaculation and pain-related impairment of sexual activity is a significant problem after laparoscopic inguinal herniorrhaphy. The role of improved laparoscopic technique with use of glue fixation of lightweight meshes to reduce the risk of developing these complications needs to be evaluated.

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References

  1. Aasvang EK, Mohl B, Bay-Nielsen M, Kehlet H (2006) Pain related sexual dysfunction after inguinal herniorrhaphy. Pain 122:258–263

    Article  PubMed  Google Scholar 

  2. Aasvang EK, Mohl B, Kehlet H (2007) Ejaculatory pain: a specific postherniotomy pain syndrome? Anesthesiology 107:298–304

    Article  PubMed  Google Scholar 

  3. Eklund A, Montgomery A, Bergkvist L, Rudberg C (2010) Chronic pain 5 years after randomized comparison of laparoscopic and Lichtenstein inguinal hernia repair. Br J Surg 97:600–608

    Article  PubMed  CAS  Google Scholar 

  4. Bittner R, Gmahle E, Gmahle B, Schwarz J, Aasvang E, Kehlet H (2010) Lightweight mesh and noninvasive fixation: an effective concept for prevention of chronic pain with laparoscopic hernia repair (TAPP). Surg Endosc 24:2958–2964

    Article  PubMed  Google Scholar 

  5. Aasvang EK, Gmaehle E, Hansen JB, Gmaehle B, Forman JL, Schwarz J, Bittner R, Kehlet H (2010) Predictive risk factors for persistent postherniotomy pain. Anesthesiology 112:957–969

    Article  PubMed  Google Scholar 

  6. Bay-Nielsen M, Kehlet H, Strand L, Malmstrøm J, Andersen FH, Wara P, Juul P, Callesen T (2001) Quality assessment of 26,304 herniorrhaphies in Denmark: a prospective nationwide study. Lancet 358:1124–1128

    Article  PubMed  CAS  Google Scholar 

  7. Breivik H, Borchgrevink PC, Allen SM, Rosseland LA, Romundstad L, Hals EK, Kvarstein G, Stubhaug A (2008) Assessment of pain. Br J Anaesth 101:17–24

    Article  PubMed  CAS  Google Scholar 

  8. Aasvang EK, Bay-Nielsen M, Kehlet H (2006) Pain and functional impairment 6 years after inguinal herniorrhaphy. Hernia 10:316–321

    Article  PubMed  CAS  Google Scholar 

  9. Grant AM, Scott NW, O’Dwyer PJ (2004) Five-year follow-up of a randomized trial to assess pain and numbness after laparoscopic or open repair of groin hernia. Br J Surg 91:1570–1574

    Article  PubMed  CAS  Google Scholar 

  10. Nienhuijs S, Staal E, Strobbe L, Rosman C, Groenewoud H, Bleichrodt R (2007) Chronic pain after mesh repair of inguinal hernia: a systematic review. Am J Surg 194:394–400

    Article  PubMed  Google Scholar 

  11. Schmedt CG, Sauerland S, Bittner R (2005) Comparison of endoscopic procedures vs Lichtenstein and other open mesh techniques for inguinal hernia repair: a meta-analysis of randomized controlled trials. Surg Endosc 19:188–199

    Article  PubMed  CAS  Google Scholar 

  12. Kehlet H (2010) Laparoscopic versus open groin hernia repair: are we getting closer to specific clinical recommendations? Hernia 14:553–554

    Article  PubMed  CAS  Google Scholar 

  13. Kehlet H (2008) Chronic pain after groin hernia repair. Br J Surg 95:135–136

    Article  PubMed  CAS  Google Scholar 

  14. Aasvang EK, Kehlet H (2008) Postherniotomy dysejaculation: successful treatment with mesh removal and nerve transection. Hernia 12:645–647

    Article  PubMed  CAS  Google Scholar 

  15. Aasvang EK, Kehlet H (2009) The effect of mesh removal and selective neurectomy on persistent postherniotomy pain. Ann Surg 249:327–334

    Article  PubMed  Google Scholar 

  16. Aasvang E, Kehlet H (2005) Chronic postoperative pain: the case of inguinal herniorrhaphy. Br J Anaesth 95:69–76

    Article  PubMed  CAS  Google Scholar 

  17. Nienhuijs SW, Boelens OB, Strobbe LJ (2005) Pain after anterior mesh hernia repair. J Am Coll Surg 200:885–889

    Article  PubMed  Google Scholar 

  18. Courtney CA, Duffy K, Serpell MG, O’Dwyer PJ (2002) Outcome of patients with severe chronic pain following repair of groin hernia. Br J Surg 89:1310–1314

    Article  PubMed  CAS  Google Scholar 

  19. Bland JM, Altman DG (1995) Multiple significance tests: the Bonferroni method. BMJ 310:170

    Article  PubMed  CAS  Google Scholar 

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Acknowledgement

Supported by a grant from the Europain project, funded by the Innovative Medicines Initiative Joint Undertaking (IMI JU, grant no. 115007).

Disclosures

Authors Joakim Bischoff, Gitte Linderoth, Eske Aasvang, Mads Werner and Henrik Kehlet have no conflicts of interest or financial ties to disclose.

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Authors and Affiliations

  1. Section of Surgical Pathophysiology 4074, Rigshospitalet, Copenhagen University, Blegdamsvej 9, 2100, Copenhagen, Denmark

    Joakim M. Bischoff, Gitte Linderoth, Eske Kvanner Aasvang & Henrik Kehlet

  2. Multidisciplinary Pain Center 7612, Rigshospitalet, Copenhagen University, Copenhagen, Denmark

    Joakim M. Bischoff & Mads U. Werner

  3. The Danish Inguinal Hernia Database, Copenhagen, Denmark

    Henrik Kehlet

Authors
  1. Joakim M. Bischoff
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  2. Gitte Linderoth
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  3. Eske Kvanner Aasvang
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  4. Mads U. Werner
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  5. Henrik Kehlet
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Correspondence to Joakim M. Bischoff.

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Bischoff, J.M., Linderoth, G., Aasvang, E.K. et al. Dysejaculation after laparoscopic inguinal herniorrhaphy: a nationwide questionnaire study. Surg Endosc 26, 979–983 (2012). https://doi.org/10.1007/s00464-011-1980-y

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  • DOI: https://doi.org/10.1007/s00464-011-1980-y

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