Prospective study of chronic pain after groin hernia repair

Background: The aim was to provide a detailed description of any residual p ain 1 year after elective day-case open groin hernia repair under local ana esthesia. Methods: This was a prospective consecutive case series study by questionna ire of 500 consecutive operations in 466 unselected adult patients 1 year a fter surgery. Pain was scored (none, mild, moderate or severe) at rest, whi le coughing and during mobilization, and compared with similar data collect ed 1 and 4 weeks after operation. Results: Some 419 questionnaires were returned (response rate 93 per cent); 20 patients had died within the year and 30 data sets from patients who ha d a subsequent operation during the study were excluded. Eighty patients (1 9 per cent) reported some degree of pain, and 25 (6 per cent) had moderate or severe pain. Pain restricted daily function in 24 patients (6 per cent). The incidence of moderate or severe pain was higher after repair of recurr ent than primary hernias (14 versus 3 per cent; P < 0.001). The risk of dev eloping moderate or severe pain was increased in patients who had a high pa in score 1 week after operation (9 versus 3 per cent; P < 0.05) and also in patients who had moderate or severe pain 4 weeks after operation (24 versu s 3 per cent; P < 0.001). Conclusion: Chronic pain is a significant problem after open groin hernia r epair. It may be worse after surgery for a recurrent hernia and may be pred icted by the intensity of early postoperative pain.