Relationship between preoperative symptoms and improvement of quality of life in patients undergoing elective inguinal herniorrhaphy

Improvement of quality of life (QoL) is the ultimate goal for inguinal hernia repair. Data on QoL before surgery are scarce, and it is not known whether postoperative improvement of QoL relates to preoperative symptoms.

Symptoms and self-reported QoL were evaluated and compared with matched control patients from a normal population in 309 male subjects before and 1 year after unilateral open inguinal hernia repair.

Before operation, 91 % of patients noted a bulge, whereas 75% had symptoms, most commonly pain (64%); the other 25% were asymptomatic. Physical QoL scores (physical component score) were decreased in patients compared with matched controls (median [interquartile range] PCS 47 [38-53] vs 54 [48-57] P < .05), whereas mental scores (mental component score) were not affected (P = .401). PCS was less in patients with pain compared with those without pain (44 [35-50] vs 53 [48-56] P = .001). In patients without pain, no difference was found compared with control patients (P = .57). At 1 year after surgery, PCS was increased to 55 (53-57) in patients and was slightly greater than control patients (P < .05). The increase was greater in patients who reported preoperative pain (from 44 [35-50] to 55 [52-57] vs from 53 [48-56] to 56 [54-57], P < .00001). MCS did not change after inguinal herniorrhaphy.

Preoperative affection as well as postoperative improvement in self-reported physical QoL seems to be strongly associated with preoperative inguinal pain. This finding underscores that occurrence of preoperative pain is an important symptom to evaluate before taking the decision to operate for inguinal hernia.