Classifying Postherniorrhaphy Pain Syndromes Following Elective Inguinal Hernia Repair

BACKGROUND: Chronic post-herniorrhaphy pain is diverse in origin. The aim of our study was to classify post-herniorrhaphy pain syndromes following elective inguinal hernia repair. PATIENTS AND METHODS: All patients with an elective inguinal hernia repair performed between January 2000 and August 2005 received a questionnaire evaluating chronic inguinal pain (visual analog scale, VAS 0-10). Patients with moderate to severe pain complaints (VAS score >or= 3) were invited for an interview and an outpatient department physical examination. RESULTS: A total of 2,164 cases underwent an elective hernia repair and received the questionnaire; 1,766 individuals responded (response rate: 81.6%). Moderate to severe pain was present in 211 patients (11.9%). Follow-up was performed in 148 patients. Three separate groups of diagnoses were identified. Group I: neuropathic pain (n = 72) indicating inguinal nerve damage; group II: non-neuropathic pain (n = 40) due to an array of diagnoses including periostitis (n = 18) and recurrent hernia (n = 13); and group III: a tender spermatic cord and/or a tight feeling in the lower abdomen (n = 43). CONCLUSIONS: Chronic pain following elective hernia repair is common and diverse in etiology but may allow for a classification contributing to the development of tailored treatment regimens.