Long-term outcome of surgical treatment of chronic postoperative groin pain: a word of caution

Hernia. 2015 Aug;19(4):587-94. doi: 10.1007/s10029-013-1125-4. Epub 2013 Jun 19.


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.

MeSH terms

  • Adult
  • Chronic Pain / surgery*
  • Device Removal
  • Female
  • Groin
  • Hernia, Inguinal / surgery*
  • Herniorrhaphy / adverse effects*
  • Humans
  • Male
  • Middle Aged
  • Neuralgia / etiology
  • Neuralgia / surgery
  • Pain, Postoperative / surgery*
  • Registries
  • Retrospective Studies
  • Surgical Mesh
  • Treatment Outcome