Causes of chronic pain after inguinal hernia repair in adults

doi:10.3877/cma.j.issn.1674-392X.2022.03.029

Abstract

Abstract:

Currently, the main treatment for inguinal hernia is still surgery, and chronic pain after hernia surgery is inevitable. The causes of chronic pain after inguinal hernia surgery are complex. We found that advanced age, female sex, some preoperative underlying diseases, high body mass index, adverse psychological factors and higher preoperative pain level are risk factors for postoperative chronic pain. The surgeon's choice of surgical method and mesh and the surgeon's operating level also have a certain impact on the occurrence of chronic pain. Postoperative infection of the mesh and incision, hematoma in the operative area, early postoperative pain and sensory abnormalities can also contribute to the development of chronic pain. Further clinical studies are needed to determine the effect of hernia type, anesthesia and mesh fixation on postoperative chronic pain. The purpose of this article is to summarize the possible causes of chronic pain after inguinal hernia surgery in adults.

Key words: Hernia, inguinal, Herniorrhaphy, Chronic pain

Xiaojun Zhu, Tao Chen, Jingyi Jiao, Huimin Xue, Chun Zhou, Peng Wang. Causes of chronic pain after inguinal hernia repair in adults[J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2022, 16(03): 370-374.

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References 40

[1]	HerniaSurge Group. International guidelines for groin hernia management[J]. Hernia, 2018, 22(1): 1-165.
[2]	Merskey H, Bogduk N. Classification of chronic pain. Description of pain terms. Prepared by the International Association for the Study of Pain. Subcommittee on Taxonomy[J]. Pain Suppl, 1986, 3: S1-226.
[3]	Mitura K, Garnysz K, Wyrzykowska D, et al. The change in groin pain perception after transabdominal preperitoneal inguinal hernia repair with glue fixation: a prospective trial of a single surgeon's experience[J]. Surg Endosc, 2018, 32(10): 4284-4289.
[4]	Pierides GA, Paajanen HE, Vironen JH. Factors predicting chronic pain after open mesh based inguinal hernia repair: a prospective cohort study[J]. Int J Surg, 2016, 29: 165-170.
[5]	Simons MP, Aufenacker T, Bay-Nielsen M, et al. European Hernia Society guidelines on the treatment of inguinal hernia in adult patients[J]. Hernia, 2009, 13(4): 343-403.
[6]	Kockling F, Hoffman H, Adolf D, et al. Female sex as independent risk factor for chronic pain following elective incisional hernia repair: registry-based, propensity score-matched comparison[J]. Hernia, 2020, 24(3): 567-576.
[7]	Reinpold W. Risk factors of chronic pain after inguinal hernia repair: a systematic review[J]. Innov Surg Sci, 2017, 2(2): 61-68.
[8]	Fillingim RB, King CD, Ribeiro-Dasilva MC, et al. Sex, gender, and pain: a review of recent clinical and experimental findings[J]. J Pain, 2009, 10(5): 447-485.
[9]	Bugada D, Lavand'homme P, Ambrosoli AL, et al. Effect of preoperative inflammatory status and comorbidities on pain resolution and persistent postsurgical pain after inguinal hernia repair[J]. Mediators Inflamm. 2016, 2016: 5830347.
[10]	Niebuhr H, Wegner F, Hukauf M, et al. What are the influencing factors for chronic pain following TAPP inguinal hernia repair: an analysis of 20, 004 patients from the Herniamed Registry[J]. Surg Endosc, 2018, 32(4): 1971-1983.
[11]	Irkulla S, Ujam B, Gaze D, et al. Abdominal adiposity is the main determinant of the C-reactive response to injury in subjects undergoing inguinal hernia repair[J]. J Inflamm(Lond), 2013, 10(1): 5.
[12]	Smit M, Werner MJM, Lansink-Hartgring AO, et al. How central obesity influences intra-abdominal pressure: a prospective, observational study in cardiothoracic surgical patients[J]. Ann Intensive Care,2016, 6(1): 99.
[13]	Johansen A, Romundstad L, Nielsen CS, et al. Persistent postsurgical pain in a general population: prevalence and predictors in the Tromso Study[J]. PAIN, 2012, 153(7): 1390-1396.
[14]	Fletcher D, Stamer UM, Pogatzki-Zahn E, et al. Chronic postsurgical pain in Europe: an observational study[J]. Eur J Anaesthesiol, 2015, 32(10): 725-734.
[15]	Andresen K, Rosenberg J. Management of chronic pain after hernia repair[J]. J Pain Res, 2018, 11: 675-681.
[16]	Andresen K, Fenger AQ, Burcharth J, et al. Mesh fixation methods and chronic pain after transabdominal preperitoneal(TAPP) inguinal hernia surgery: a comparison between fibrin sealant and tacks[J]. Surg Endosc, 2017;31(10): 4077-4084.
[17]	邱欣国. 无张力疝修补术后疼痛的临床分析[J]. 中国现代医生, 2014, 52(4): 4-6, 10.
[18]	秦平. 无张力疝修补术后慢性疼痛相关因素分析[J]. 临床医学研究与实践, 2017, 2(32): 70-71.
[19]	Johansen N, Vyrdal CD, Bisgaard T. nationwide results on chronic pain after bilateral transabdominal preperitoneal inguinal hernia repair[J]. Scand J Surg, 2020, 109(4): 289-294.
[20]	Liu Y, Zhou MQ, Zhu XW, et al. Risk and protective factors for chronic pain following inguinal hernia repair: a retrospective study[J]. J Anesth, 2020, 34(3): 330-337.
[21]	Graham D, Queen IM, Chen D. Inguinal neuroanatomy: implications for prevention of chronic postinguinal hernia pain[J]. Int J Abdom Wall Hernia Surg, 2018, 1(1): 1-8.
[22]	裘之瑛, 陈悦, 唐健雄, 等. 开放式前入路腹股沟疝修补术后慢性疼痛的超声诊断[J/OL]. 中华疝和腹壁外科杂志(电子版), 2018, 12(2): 108-112.
[23]	Cunningham J, Temple WJ, Mitchell P, et al. Cooperative hernia study. Pain in the postrepair patient[J]. Ann Surg, 1996, 224(5): 598-602.
[24]	Reinpold W. Risk factors of chronic pain after inguinal hernia repair: a systematic review[J]. Innov Surg Sci, 2017, 2(2): 61-68.
[25]	Aiolfi A, Cavalli M, Ferraro SD, et al. Total extraperitoneal(TEP) versus laparoscopic transabdominal preperitoneal(TAPP) hernioplasty: systematic review and trial sequential analysis of randomized controlled trials[J]. Hernia, 2021, 25(5): 1147-1157.
[26]	Bracale U, Melillo P, Pignata G, et al. Which is the best laparoscopic approach for inguinal hernia repair: TEP or TAPP? A systematic review of the literature with a network meta-analysis[J]. Surg Endosc, 2012, 26(12): 3355-3366.
[27]	Mandujano CC, Tchokouani L, Lima DL, et al. Robotic mesh explantation(RoME): a novel approach for patients with chronic pain following hernia repair[J]. Surg Endosc, 2021, 36(7): 4862-4868.
[28]	Ravo B, Falasco G. Pure tissue inguinal hernia repair with the use of biological mesh: a 10-year follows up. A prospective study[J]. Hernia, 2020, 24(1): 121-126.
[29]	Ruiz-Jasbon F, Ticehurst K, Ahonen J, et al. Results at 3-year follow-up of totally extraperitoneal(TEP) hernia surgery with long-term resorbable mesh[J]. Hernia, 2020, 24(3): 669-676.
[30]	Akalin C, Karagulle OO. The effects of onlay titanium-coated mesh on recurrence, foreign body sensation and chronic pain after ventral hernia repair[J]. Asian J Surg, 2021, 44(9): 1158-1165.
[31]	Scheidbach H, Tannapfel A, Schmidt U, et al. Influence of titanium coating on the biocompatibility of a heavyweight polypropylene mesh. An animal experimental model[J]. Eur Surg Res, 2004, 36(5): 313-317.
[32]	Molegraaf MJ, Grotenhuis B, Torensma B, et al. The HIPPO Trial, a randomized double-blind trial comparing self-gripping parietex progrip mesh and sutured parietex mesh in Lichtenstein hernioplasty: a long-term follow-up study[J]. Ann Surg, 2017, 266(6): 939-945.
[33]	Andresen K, Fenger AQ, Burcharth J, et al. Mesh fxation methods and chronic pain after transabdominal preperitoneal(TAPP) inguinal hernia surgery: a comparison between fbrin sealant and tacks[J]. Surg Endosc, 2017, 31(10): 4077-4084.
[34]	Chan MS, Teoh AY, Chan KW, et al. Randomized double-blinded prospective trial of fibrin sealant spray versus mechanical stapling in laparoscopic total extraperitoneal hernioplasty[J]. Ann Surg, 2014, 259(3): 432-437.
[35]	Romario UF, Puccetti F, Elmore U, et al. Self-gripping mesh versus staple fixation in laparoscopic inguinal hernia repair: a prospective comparison[J]. Surg Endosc, 2013, 27(5): 1798-1802.
[36]	Tolver MA, Rosenberg J, Juul P, et al. Randomized clinical trial of fifibrin glue versus tacked fifixation in laparoscopic groin hernia repair[J]. Surg Endosc, 2013, 27(8): 2727-2733.
[37]	Gutlic N, Rogmark P, Nordin P, et al. Impact of mesh fixation on chronic pain in total extraperitoneal inguinal hernia repair(TEP): a nationwide register-based study[J]. Ann Surg, 2016, 263(6): 1199-1206.
[38]	Manangi M, Shivashankar S, Vijayakumar A. Chronic pain after inguinal hernia repair[J]. Int Sch Res Notices, 2014, 2014: 839681.
[39]	Olsson A, Sandblom G, Franneby U, et al. Do postoperative complications correlate to chronic pain following inguinal hernia repair? A prospective cohort study from the Swedish Hernia Register[J]. Hernia, 2021: 1-9.
[40]	Lange JFM, Meyer VM, Voropai DA, et al. The role of surgical expertise with regard to chronic postoperative inguinal pain(CPIP) after Lichtenstein correction of inguinal hernia: a systematic review[J]. Hernia, 2016, 20(3): 349-356.

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