scholarly journals Chronic Pain after Inguinal Hernia Surgery, which Improved after Laparoscopic Resection of the Mesh: A Case Report

Author(s):  
Koji Matsushita ◽  
Yoshiaki Mihara ◽  
Nobumi Tagaya ◽  
Naoki Ohashi ◽  
Toshimasa Yatsuoka
2018 ◽  
Vol 84 (12) ◽  
pp. 1932-1937
Author(s):  
Anna-Maria ThÖLix ◽  
Jyrki Kössi ◽  
Veikko Remes ◽  
Tom Scheinin ◽  
Jukka Harju

Chronic groin pain after inguinal hernia mesh repair is a common problem. Mesh fixation without sutures has been suggested to have several advantages over the traditional suture fixation. The aim of this study was to compare two self-adhering meshes, the glued Adhesix® (AH) and the gripping Parietene ProGrip® (PP), and evaluate their impact on postoperative chronic pain and overall recovery. Two consultant surgeons performed altogether 393 open inguinal hernia operations at the Helsinki University Hospital during 2014 to 2015. The two groups, AH (n = 169) and PP (n = 224) were similar and comparable in terms of demographic data. The data were collected and analyzed from the patients’ medical records in the hospital's register. The patients were followed up for a period of 19 months (5-31 months). The number of patient contacts due to postoperative pain was significantly less common in the AH group than in the PP group, 4/169 (2.4%) versus 19/224 (8.5%) patients, respectively ( P = 0.011). The duration of pain was under three months for most patients, only two patients in the PP group had pain for over one year. The pain was treated most patients with anti-inflammatory painkillers, whereas injections of a local anesthetic and corticosteroid, and chronic pain medication was needed in some cases. It seems that the use of glue-coated mesh (Adhesix®) was associated with less postoperative visits due to pain compared with the self-fixating mesh with absorbable anchoring system (ProGrip®). Further studies with long-term follow-up are needed to confirm these results.


2017 ◽  
Vol 24 (3) ◽  
pp. 289-298 ◽  
Author(s):  
Stina Öberg ◽  
Kristoffer Andresen ◽  
Jacob Rosenberg

Purpose. Absorbable meshes used in inguinal hernia repair are believed to result in less chronic pain than permanent meshes, but concerns remain whether absorbable meshes result in an increased risk of recurrence. The aim of this study was to present an overview of the advantages and limitations of fully absorbable meshes for the repair of inguinal hernias, focusing mainly on postoperative pain and recurrence. Methods. This systematic review with meta-analyses is based on searches in PubMed, Embase, Cochrane, and Psychinfo. Included study designs were case series, cohort studies, randomized controlled trials (RCTs), and non-RCTs. Studies had to include adult patients undergoing an inguinal hernia repair with a fully absorbable mesh. Results. The meta-analyses showed no difference in recurrence rates (median 18 months follow-up) and chronic pain rates (1 year follow-up) between absorbable- and permanent meshes. Crude chronic pain rates for the RCTs were 2.1% for the absorbable meshes and 7.6% for the permanent meshes. For the absorbable meshes, medial hernias were more susceptible for recurrence compared with lateral hernias ( P < .0005). None of the studies reported allergic reactions or other serious adverse events related to the absorbable mesh. Conclusions. Patients with an absorbable mesh seem to have less chronic pain following inguinal hernia surgery compared with permanent meshes, without increased risk of recurrence.


2021 ◽  
pp. 21-24
Author(s):  
Shiv Kumar Bunkar ◽  
Anushree Jhunjhunwala ◽  
Kalpana Agrawal

BACKGROUND: The face of inguinal hernia surgery has been under constant evolution with improvements in surgical technique; together with the development of new prosthetic materials and a better understanding of how to use them. Till date, prevention of recurrence was the primary goal of any hernia surgery. With the advent of newer techniques the current focus has shifted to minimizing post-operative pain while continuing to ensure that the primary goal is met. The objective of our study was to compare suture xation of the mesh with non-mechanical xation using nbutyl cyanoacrylate (NBCA) glue for open inguinal hernia repair. METHODS: A prospective randomized controlled study was carried out at the General surgery department of J.L.N. Hospital, Ajmer between January 2019 and January 2020 consisting of 120 patients with uncomplicated inguinal hernia undergoing standard Lichenstein's mesh hernioplasty. Endpoints studied were postoperative acute and chronic pain, analgesic requirement in the post-operative period, duration of surgery and complications in the post operative period. RESULTS: Operative time was signicantly lesser in glue group as compare to suture group. There was no signicant difference in the post-operative pain during the entire timeline except at 24 hrs post procedure. However, 2 patients in suture group had chronic pain and complained of mild pain at 6 months follow up and even beyond. Post-operative complications were comparable in both groups. CONCLUSION: Our study help us to conclude that mesh xation with N butyl 2 cyanoacrylate glue is superior to sutures in several aspects.


2017 ◽  
Vol 11 (1) ◽  
Author(s):  
Hiroshi Asano ◽  
Saori Yajima ◽  
Yoshie Hosoi ◽  
Makoto Takagi ◽  
Hiroyuki Fukano ◽  
...  

2012 ◽  
Vol 3 (3) ◽  
pp. 188-188
Author(s):  
Maija Kalliomäki ◽  
Anne-Li Lind ◽  
Alfhild Grönbladh ◽  
Ulf Gunnarsson ◽  
Gabriel Sandblom ◽  
...  

Abstract Aim of investigation Persistent postoperative pain of some extent is seen in about 20% of patients after surgical operations, while 80% heal without chronic pain. The type of chronic pain that arises is mainly neuropathic, and is suggested to be in part regulated by genetic factors. In order to study the possible involvement of some candidate genes suggested to be involved in the processing of pain (BDNF, CACNA2D2, ORPM1, GRIK 3, GCH1 and TNF-α ), we performed a genetic association study in a well characterized clinical material of patients that had undergone surgery for inguinal hernia (n = 189). Of those 94 had developed a persistent postoperative pain state when investigated 2–3 years following the operation. The control group (n = 95) had undergone the same surgical procedure, and were pain free at follow up. Methods Genomic DNA was extracted from blood samples and genotyped by the Handy Bio-strand method and the TaqMan assay. Results The patients with persistent postoperative pain that had homozygous SNP in the TNF-α gene displayed increased risk of persistent postoperative pain with an odds risk of 2.42, compared the pain free controls. None of the other of the investigated genes were associated with significant risk of development of chronic pain following surgery. Conclusion The expression of TNF-α shows a significant impact on the risk of developing chronic pain after surgery. Further experimental and clinical studies are needed in order to fine map the TNF-α effect and to address underlying mechanisms.


2017 ◽  
Vol 31 (10) ◽  
pp. 4077-4084 ◽  
Author(s):  
Kristoffer Andresen ◽  
Andreas Q. Fenger ◽  
Jakob Burcharth ◽  
Hans-Christian Pommergaard ◽  
Jacob Rosenberg

2013 ◽  
Vol 4 (4) ◽  
pp. 258-258
Author(s):  
C.A. Dominguez ◽  
M. Kalliomäki ◽  
U. Gunnarsson ◽  
A. Moen ◽  
G. Sandblom ◽  
...  

Abstract Neuropathic pain conditions are common after nerve injuries and are suggested to be regulated in part by genetic factors. We have previously demonstrated a strong genetic influence of the rat major histocompatibility complex on development of neuropathic pain behavior after peripheral nerve injury. In order to study if the corresponding human leukocyte antigen complex (HLA) also influences susceptibility to pain, we performed an association study in patients that had undergone surgery for inguinal hernia (n = 189). One group had developed a chronic pain state following the surgical procedure, while the control group had undergone the same type of operation, without any persistent pain. HLA DRB1genotyping revealed a significantly increased proportion of patients in the pain group carrying DRB1(*)04 compared to patients in the pain-free group. Additional typing of the DQB1 gene further strengthened the association; carriers of the DQB1(*)03:02 allele together with DRB1(*)04 displayed an increased risk of postsurgery pain with an odds risk of 3.16 (1.61-6.22) compared to noncarriers. This finding was subsequently replicated in the clinical material of patients with lumbar disc herniation (n = 258), where carriers of the DQB1(*)03:02 allele displayed a slower recovery and increased pain. In conclusion, we here for the first time demonstrate that there is an HLA-dependent risk of developing pain after surgery or lumbar disc herniation; mediated by the DRB1(*)04-DQB1(*)03:02 haplotype. Further experimental and clinical studies are needed to fine-map the HLA effect and to address underlying mechanisms.


2010 ◽  
Vol 87 (4) ◽  
pp. 199-201
Author(s):  
Pilar Hernández Granados

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