O17 CHRONIC GROIN PAIN DUE TO OR DESPITE THE HERNIA REPAIR

Abstract Aim There is a discrepancy between the high frequency of chronic post-operative pain reported in questionnaire-based studies after groin hernia surgery and the clinical experience of many surgeons in which it is infrequent that patients return after surgery because of chronic post-operative pain. This is supported by the Swedish Hernia Registry, where the proportion of patients who are re-operated for chronic post-operative pain is 0.02-0.03% for open methods and less than 0,01% for laparo-endoscopic methods. The aim of this study is to find the incidence of non-surgical causes of chronic groin pain and other patient-reported outcomes after inguinal hernia surgery. Material and Methods Prospective cohort observation study of patients evaluated for suspected inguinal hernia-related symptoms at a hernia clinic in Sweden during 1 year. Patients completed validated pain forms before surgery and 6 and 12 months after surgery. Patients were assessed preoperatively about the possible causes of groin pain according to a checklist. For this purpose, a questionnaire of inguinal hernia-related symptoms was used. Patients with moderate or severe chronic groin pain after surgery were offered to participate in a clinical examination where the pain was evaluated for probable cause according to a checklist. Results 574 patients were included in the study, of which 372 were operated on and answered the post-operative questionnaires. Preliminary results on surgical and non-surgical causes of chronic groin pain after hernioplasty and other patient-reported outcomes will be presented at Hernia 2021 EHS-AHS Joint Congress. Conclusions Proportion of patients with chronic groin pain related to groin hernia surgery and other non-surgical pathologies will be reported.

Download Full-text

A comparative study of mesh fixation with polypropylene sutures (prolene) versus polyglactin sutures (vicryl) sutures in assessing inguinodynia in open inguinal hernia repair

International Surgery Journal ◽

10.18203/2349-2902.isj20210925 ◽

2021 ◽

Vol 8 (3) ◽

pp. 904

Author(s):

Ramesh S. Koujalagi ◽

Vinod Karagi ◽

Abhijit S. Gogate ◽

Nikhil M.

Keyword(s):

Inguinal Hernia ◽

Hernia Repair ◽

Groin Pain ◽

Mesh Fixation ◽

Chronic Groin Pain ◽

Post Operative Pain ◽

Severity Scores ◽

Group A ◽

Polypropylene Sutures

Background: Inguinal hernia, the most frequently occurring type of hernia globally, Chronic groin pain could be related to nerve mangling while operating. Mesh repair can lead to an inflammatory reaction over a period of time, though it still needs ground work to find out exact cause of pain. So this study aims to compare the effectiveness of polyglactin versus prolene sutures in reducing the post-operative pain in inguinal hernia repair.Methods: A one year hospital prospective study in KLE hospital. A total of 60 adult patients were divided into two groups of 30 each. Mesh fixation with polyglactin sutures was group A (30) and mesh fixation with polypropylene sutures was group B (30) and then post-operative pain, was assessed. Follow-up was for 3 months. Collected data was analyzed using chi–square tests, Mann-Whitney U tests.Results: Our analysis showed that the incidence of postoperative groin pain with mean severity scores of 1.37±0.49 versus 1.43±0.50; 1.40±0.50 versus 1.57±0.73; 1.03±0.61 versus 1.50±0.057; 0.77±0.63 versus 1.30±0.79; at post-operative day 1, 3 in both groups were similar and statistically not significant whereas the 1 week and 3 months follow up in group A and B respectively, were significant (p<0.05).Conclusions: The post-op chronic groin pain is significantly low, hence routine usage of polyglactin sutures to fix a mesh is a safe and effective alternative to polypropylene sutures in Lichtenstein hernia repair.

Download Full-text

Post-Operative Outcome of Desarda Repair of Inguinal Hernia in Emergency Case in Bangladesh

Journal of Current and Advance Medical Research ◽

10.3329/jcamr.v7i1.46430 ◽

2020 ◽

Vol 7 (1) ◽

pp. 44-48 ◽

Cited By ~ 1

Author(s):

SM Iftekhar Uddeen Sagar ◽

SM Nazrul Islam ◽

Md Abul Kalam Azad ◽

Mohammad Khaleduzzaman Khan ◽

Muhammad Mofazzal Hossain ◽

...

Keyword(s):

Inguinal Hernia ◽

Hernia Repair ◽

Hospital Stay ◽

Groin Pain ◽

Operating Time ◽

Early Recurrence ◽

Chronic Groin Pain ◽

Post Operative Pain ◽

Operative Complications ◽

Post Operative Complications

Background: Desarda hernia repair has emerged as a recognized operative method for inguinal hernia repair. Objective: The purpose of the present study was to see the outcome of emergency inguinal hernia repair by Desarda technique. Methodology: This was an observational study was carried out in the Department of Surgery at Sher-E-Bangla Medical College Hospital, Barisal, Bangladesh and Private Hospital, Narayanganj, Bangladesh from August 2015 to January 2017. Twenty patient was operated by Desarda technique. Variables includes age, operating time, post-operative complications, post-operative hospital stay, cost of the procedure, chronic groin pain and any early recurrence. Result: Mean age of patient 50.25±18.9, Mean operating time was 78.4±9.64 mins. Majority 16 patient experienced mild post-operative pain measured in VAS score. Mean with SD of hospital stay was 5.05±2.16 days. Patient had developed different post-operative complications like wound infection in 2(10.0%) cases, scrotal edema in 5(25.0%) cases, seroma formation in 1(5.0%) case and no early recurrence and. Conclusion: In this study, it revealed that Desarda repair was associated with less post-operative complications, less post-operative pain, zero recurrence rate, no chronic groin pain and performed in emergency cases. So it is safe and most reliable technique for complicated (Incarcerated, Obstructed, Strangulated) inguinal hernia. Journal of Current and Advance Medical Research 2020;7(1): 44-48

Download Full-text

Repair of inguinal hernia by Desarda technique in both elective and emergency setting

Bangladesh Medical Research Council Bulletin ◽

10.3329/bmrcb.v45i3.44649 ◽

2019 ◽

Vol 45 (3) ◽

pp. 180-184

Author(s):

S.M. Iftekhar Uddeen Sagar ◽

Muhammad Syeef Khalid ◽

Abu Sayeed Md. Feroz Mustafa ◽

SM Nazrul Islam

Keyword(s):

Inguinal Hernia ◽

Hernia Repair ◽

Hospital Stay ◽

Inguinal Hernia Repair ◽

Groin Pain ◽

Operating Time ◽

Chronic Groin Pain ◽

Post Operative Pain ◽

Operative Complications ◽

Post Operative Complications

Background: Inguinal hernia is a common problem and its repair is one of the most commonly performed procedures in general surgical practice. Several methods have been developed including Lichtenstein’s repair. Among these Lichtenstein’s repair has been standard technique for last few decades. In recent time a new procedure “no mesh Desarda hernia repair” has emerged as a recognized operative method for inguinal hernia repair. Objectives: This study was conducted to evaluate the outcome of Desarda technique in repairing inguinal hernia. Methods: This was a single centered descriptive study to see the outcome of inguinal hernia repair by Desarda technique in both elective and emergency surgery carried out in the Dept. of Surgery, Sher-E-Bangla Medical College Hospital, Barisal from August, 2015 to July, 2016. Results: A total of 100 patients underwent Desarda repair for inguinal hernia including primary/recurrent and elective/ emergency cases. Variables includes age, type of surgery, operating time, post-operative complications, post-operative pain, post-operative hospital stay, cost of the procedure, chronic groin pain and any early recurrence. Mean age of patient was 48.9±9.07 years. Mean operating time was 43.72±9.64mins. Majority (54%) of the patient experienced mild post-operative pain on first day, measured in VAS score. Ten percent of patients developed different post-operative complications like wound infection (2%), seroma formation (1%) and scrotaledema (7%). Conclusion: In this study, it is revealed that no mesh Desarda repair for inguinal hernia was associated with less operating time, less post-operative pain, less post-operative complications, short hospital stay, zero recurrence rate, no chronic groin pain and performed in emergency cases also. So, it is safe and most reliable technique for all type of inguinal hernia surgery.

Download Full-text

Chronic Post-Inguinal Herniorrhaphy Pain in a Setting in Rural Africa

Journal of Advances in Medicine and Medical Research ◽

10.9734/jammr/2021/v33i1631001 ◽

2021 ◽

pp. 53-58

Author(s):

Richard Wismayer

Keyword(s):

Inguinal Hernia ◽

Groin Pain ◽

Hospital Setting ◽

Chronic Groin Pain ◽

Hernia Surgery ◽

Ilioinguinal Nerve ◽

Male Predominance ◽

Inguinal Hernia Surgery ◽

Routine Identification ◽

Rural Africa

Introduction: In Africa, inguinal hernia is a common surgical condition with an incidence of 175 inguinal hernias per 100,000 people each year. Pain that persists for at least a duration of 3 months postoperatively following repair of an inguinal hernia defines chronic groin pain. The objective of this study was to determine the prevalence of chronic groin pain in a group of patients in a hospital setting in rural Africa. Methodology: A descriptive retrospective study was carried out between 1st April 2008 to the 31st July 2012 on all patients ≥15 years of age that underwent an inguinal hernia repair were eligible in this study. Data was retrieved from patients’ clinical notes and theatre log books on age, sex, recurrence of hernia and post-operative pain lasting at least 3 months. Data obtained in the interview questionnaire included duration of pain, pain at the operation site, type of postoperative analgesia and a physical examination to determine recurrence was performed in the surgical-out-patients clinic. Results: One hundred and fifty eight patients following repair of inguinal hernia using the modified Bassini technique were analysed. Mean age was 44.84 years. The male:female ratio was 3.65:1 with a male predominance. Chronic groin pain/discomfort was reported in 22(13.92%) and this pain/discomfort lasted for at least 3 months post-operatively. Conclusions: The low incidence of chronic groin pain in our study may be due to the majority of them being operated as elective procedures under local anaesthesia with routine identification of the ilioinguinal nerve. However, a study with a larger sample size and a longer follow up may be required to ascertain the true prevalence of chronic groin pain following inguinal hernia surgery in rural Africa.

Download Full-text

A Prospective Comparative Study in Laparoscopic Inguinal Hernia Repair with Regard to Fixation and Non-Fixation of Mesh in a Tertiary Care Centre in Northern India

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2021/448 ◽

2021 ◽

Vol 8 (27) ◽

pp. 2417-2422

Author(s):

Sanjay Kala ◽

Ramendra Kumar Jauhari ◽

Anurag Singh ◽

Abhishek V. Kulkarni

Keyword(s):

Inguinal Hernia ◽

Groin Pain ◽

Mesh Fixation ◽

Laparoscopic Inguinal Hernia Repair ◽

Chronic Groin Pain ◽

Care Centre ◽

Northern India ◽

Laparoscopic Inguinal Hernia ◽

Post Operative Pain ◽

Prospective Comparative Study

BACKGROUND The debate between fixation and non-fixation of mesh in laparoscopic hernia surgery has been going since the advent of this technique. While earlier studies insisted on mesh fixation, emerging studies are now supporting elimination of mesh fixation. Therefore, a prospective comparative study was performed in tertiary health care centre in northern India to compare the incidence of recurrence, post-operative pain and chronic groin pain between mesh fixation and non-fixation. In this study, we wanted to compare the intra-operative complications, post-operative pain and recovery, duration of hospital stay, incidence of chronic groin pain and pain during follow up visits and incidence of recurrence in laparoscopic inguinal hernia repair between fixation and non-fixation of mesh. METHODS A prospective comparative study was conducted among 50 patients admitted in surgery unit in a tertiary health care centre in northern India from January 2019 to October 2020 and were divided into two groups (group A - fixation, group B - non-fixation). Different factors such as post-operative pain, analgesia required post-operatively, duration of hospital stay, chronic groin pain and recurrence were compared between the two groups. Patients were followed up at 1, 3, 6 and 12 months. RESULTS The mean pain score at the end of 1 month and 3 months was higher in patients in the mesh fixation group. The days required by patients to resume their routine activities was lesser in patients in the non-fixation group. The recurrence rate was found to be similar in both the groups. CONCLUSIONS Mesh fixation offers no clear advantage over non-fixation and non-fixation can be considered as the preferred alternative as this procedure has less chance of postoperative pain, early ambulation and no increased risk of recurrence. KEYWORDS Laparoscopic Inguinal Hernia Repair, Mesh Fixation, Mesh Non-Fixation

Download Full-text

Status of self-medication among the patients attending outpatient department in selected private hospitals in Dhaka city

Bangladesh Medical Research Council Bulletin ◽

10.3329/bmrcb.v45i3.44650 ◽

2019 ◽

Vol 45 (3) ◽

pp. 185-190

Author(s):

Md. Riyadh Hasan ◽

Nawzia Yasmin ◽

Nuhad Raisa Seoty ◽

Md. Maniul Hasan ◽

Maj. Gen. (Retd) Dr. M Shahjahan

Keyword(s):

Inguinal Hernia ◽

Hernia Repair ◽

Hospital Stay ◽

Inguinal Hernia Repair ◽

Groin Pain ◽

Operating Time ◽

Chronic Groin Pain ◽

Post Operative Pain ◽

Operative Complications ◽

Post Operative Complications

Download Full-text

Faculty Opinions recommendation of Chronic groin pain, discomfort and physical disability after recurrent groin hernia repair: impact of anterior and posterior mesh repair.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.725953073.793533330 ◽

2017 ◽

Author(s):

Darin Correll

Keyword(s):

Hernia Repair ◽

Physical Disability ◽

Mesh Repair ◽

Groin Hernia ◽

Groin Pain ◽

Chronic Groin Pain ◽

Groin Hernia Repair ◽

Recurrent Groin

Download Full-text

950 Experience of Inguinal Mesh Hernioplasty Under Local Anaesthesia: A 3-Year Experience in A Teaching Hospital

British Journal of Surgery ◽

10.1093/bjs/znab134.592 ◽

2021 ◽

Vol 108 (Supplement_2) ◽

Author(s):

Z Hashmi ◽

R Ahmed ◽

T Zafar ◽

M Ahmed ◽

N Yousaf ◽

...

Keyword(s):

Local Anaesthesia ◽

Groin Pain ◽

Clinical Judgement ◽

Chronic Groin Pain ◽

Day Case ◽

Post Operative Pain ◽

The Mean ◽

Mesh Hernioplasty ◽

Operating Surgeon

Abstract Objective To prove Inguinal mesh hernioplasty under L/A is safe and acceptable. Helps with post-operative pain and enables rapid recovery as a day case. Method All patients who underwent inguinal hernia repair under local anaesthesia were retrospectively analysed in our hospital between July 2014- July 2017. Clinical judgement was used for inclusion and exclusion parameters. Results From July 2014- July 2017, 260 patients were included in study who underwent Inguinal mesh hernioplasty under L/A. ASA grade for all patients ranged between I-III. The mean age was 37 (20-65). Intraoperatively (9.1) 3.5% patients had problems such as pain, hypotension or sweating. About (86.3%) 224 patients were discharged home the same day and remaining stayed overnight for less than 24 hours. Hematoma was seen in 5 (1.92%) patients, Urinary retention in 2 (0.7%) patients, Wound infection seen in 24(9.2%) patients, Readmission in 10 (3.8%) patients. Chronic groin pain was seen in 10 (3.9%) patients and no recurrence on 6 months follow up. Conclusions Our results showed that this procedure is feasible under L/A and can be performed safely. It showed satisfactory acceptance by the operating surgeon and patient, without significant perioperative issues. It is reliable and showed shorter hospital stay.

Download Full-text