Pain and functional impairment 1 year after inguinal herniorrhaphy: A nationwide questionnaire study

Objective To determine the incidence of groin pain 1 year after inguinal herniorrhaph y and to assess the influence of chronic groin pain on function. Summary Background Data The reported incidence of chronic pain after inguinal herniorrhaphy varies from 0% to 37%. No cross-sectional cohort studies with high follow-up rates have addressed this problem, and there is a lack of assessment of the func tional consequences of chronic groin pain after herniorrhaphy. Methods Two sets of self-administered questionnaires were mailed 1 year after surge ry. The first established the incidence of chronic groin pain. The second c haracterized the pain and the effect of the pain on the function of those r eporting pain. The study population comprised patients older than age 18 ye ars registered in the Danish Hernia Database who underwent surgery between February 1, 1998, and March 31, 1998. Results The response rate to the first questionnaire was 80.8%. Pain in the groin a rea was reported by 28.7%, and 11.0% reported that pain was interfering wit h work or leisure activity. Older patients had a lower incidence of pain. T here were no differences in the incidence of pain with regard to the differ ent types of hernia, the different types of surgical repairs, or the differ ent types of anesthesia. The second questionnaire was returned by 83%. Of t hese, 46 (4%) reported constant pain. The intensity of pain while at rest w as moderate or severe in 40 (3%); with physical activity, pain was moderate or severe in 91 (8%). Impairment of specific daily activities as a result of pain was reported by 194 (16.6%). Pain characteristics were predominantl y sensory, with a low use of affective terms. Conclusion One year after inguinal hernia repair, pain is common (28.7%) and is associ ated with functional impairment in more than half of those with pain. These factors should be addressed when discussing the need for surgical interven tion for an inguinal hernia.