Management of chronic postoperative groin pain

Postoperative groin pain is a common complaint following surgery of the abdomen and groin. Although this pain usually resolves in the early postoperative period, some experience prolonged, debilitating pain lasting months to years. There is currently a lack of consensus as to the appropriate transition from medical to surgical management of these patients. A retrospective review of 19 consecutive patients with postoperative pain symptoms suspicious for neuropathic origin was undertaken. Neuromas or entrapment of 1 or more nerves was identified in all patients. Improvement of pain and quality of life was reported in 84%, with a minimum 1 year's follow-up. Average preoperative and postoperative pain was 7.6 and 1.2, respectively, a statistically significant reduction. This study confirms high success rates for patients surgically treated for chronic postoperative groin pain when proper selection criteria and appropriate surgical techniques are applied. A management approach is proposed and the surgical technique is described for treatment of these patients.