Purpose: Chronic postoperative groin pain is widely accepted to be a serious clinical condition after inguinal hernia repair and Pfannenstiel incision. Surgical treatment has been reported to be effective, but the long-term outcome following these interventions remains unclear. This retrospective study reports the outcome and investigates patient and intra-operative factors to identify possible predictors of success. A literature review of other outcome studies with more than 1 year follow-up is also presented.
Methods: A registry of patients who underwent surgery for chronic postoperative groin pain was analyzed. Pain was assessed using DN4-score and VAS-scale. Primary endpoint was successful pain reduction, as defined by the ratio of VASmax (post/pre) and the subjective outcome (better vs. same-worse).
Results: Fifteen patients underwent surgery for chronic postoperative groin pain between December 2000 and April 2010. Overall, significant pain reduction was achieved in 1/3 of patients. There was no significant association between patient or intra-operative factors and favorable outcome. A complete concordance between subjective outcome and the ratio of VASmax (post/pre) was noted.
Conclusion: The success of surgery for chronic postoperative groin pain is difficult to predict. In this study, one in three patients benefits from an operative treatment. The ratio of VASmax (post/pre) is suggested as a useful pain assessment tool. A further prospective study of sufficient sample size is necessary to identify possible factors associated with favorable outcome after surgery for chronic groin pain.