Reoperation for persistent pain after groin hernia surgery: a population-based study

The aim of the present study was to assess the outcome results after reoperation for persistent pain after hernia surgery in a population-based setting.

All patients who had undergone surgery for persistent pain after previous groin hernia surgery 1999-2006 were identified in the Swedish Hernia Register (n = 237). Data on the surgical technique used were abstracted from the medical records. The patients were asked to answer a set of questions including SF-36 to evaluate the prevalence of pain after reoperation.

The study group consisted of 95 males and 16 females, mean age 53 years. In 27 % of cases an intervention aimed at suspected ilioinguinal neuralgia was performed. The mesh was removed completely in 28% and partially in 13%. A suture at the pubic tubercle was removed in 13% of cases. Decrease in pain after the most recent reoperation was reported by 69 patients (62%), no change in pain by 21 patients (19%) and increase in pain in 21 patients (19%). There was no significant difference in outcome between mesh removal, removal of sutures at the tubercle or interventions aimed at the ilioinguinal nerve. All subscales of SF-36 were significantly reduced when compared to the age- and gender-matched general population (p < 0.05).

Patients reoperated for persistent pain after hernia surgery often report a reduction in pain, but the natural course of persistent pain, the relatively low response rate and selection of patients make it difficult to draw definite conclusions.