Chronic pain after Lichtenstein and preperitoneal (posterior) hernia repair

Hernia repair is one of the most common surgical procedures, and some patients suffer from chronic pain after hernia surgery. The aim of the present study was to evaluate chronic postherniorrhaphy pain in men who underwent Lichtenstein mesh repair or preperitoneal (posterior) repair.

Our study included 94 male inpatients. Two surgeons experienced in both Lichtenstein and preperitoneal hernia repair performed the procedures. We controlled postoperative pain with systemic analgesic therapy. We evaluated the patients over the subsequent 12 months, using a questionnaire to focus on chronic pain and its limitations to their quality of life.

The overall incidence of chronic pain at 2 months was 5%. About 6% of patients who underwent Lichtenstein repair (n = 70) and 4% of patients who underwent preperitoneal repair (n = 24) experienced chronic pain. All patients with chronic pain rated their pain as slight or moderate. Their pain was present occasionally and was related to physical stress. None of the patients were unable to work. After 12 months of follow-up, the overall incidence of chronic pain decreased to 3%, with 3 patients in Lichtenstein group reporting chronic pain with slight limitations in sports and social activities.

The incidence rates of chronic pain after Lichtenstein and preperitoneal repair were 6% and 4%, respectively. Inpatient status might have resulted in low incidences with both approaches.