The Long-Term Outcome of Surgical Treatment in Patients With Chronic Postoperative Inguinal Pain

Abstract Background Surgical treatment for patients with chronic postoperative inguinal pain (CPIP) remains very challenging since there has been no consensus which procedure would be appropriate. The aim of the present study is to verify the effectiveness of surgical procedures for patients with CPIP by the patient-reported outcome measures. Methods Between February 2017 and May 2023, 50 patients who underwent surgery for CPIP in our institution were evaluated. A questionnaire survey was performed by post or at the outpatient clinic between January 2023 and December 2023. Surgical procedure was decided individually considering sort of pain and a previous surgical procedure. Outcome measures were complications, satisfaction (excellent/good/moderate/poor), and hernia recurrence rate. Results Among the study period, 50 patients underwent 53 surgeries for CPIP. Median age was 60 years old. There were 41 males and 9 females. Median duration from the primary hernia repair to surgery for CPIP was 28.8 months. A previous surgical procedure was Lichtenstein (n = 4), Bilayer (n = 5), mesh and plug repair (n = 11) Kugel repair (n = 2), TIPP (n = 10), laparoscopic repair (n = 16), and tissue repair (n = 2). Surgery for CPIP was performed via laparoscopy (n = 22), open anterior (n = 6), and both approaches (n = 25). Postoperative severe complications occurred in 3 patients (reoperation, abscess, and postoperative hemorrhage). A questionnaire was returned by 48 of 50 patients (96%). An 88% excellent/good long-term result was achieved (median 24.6 months). Two hernia recurrence was observed (4%). Conclusions An 88% of Patients suffering from CPIP that was refractory to alternative pain treatment benefited from surgery for CPIP.