A Novel One-Stop Multidisciplinary Clinic for Chronic Postoperative Inguinal Pain: Initial Experiences and Outcomes

Chronic Postoperative Inguinal Pain (CPIP) affects 10%-20% of patients following inguinal hernia repair, persisting for over 3 months post-surgery. It involves a complex interplay of neuropathic and nociceptive pain, secondary sensitization, and functional and psychological impacts. The condition often coexists with other pain causes, complicating diagnosis and treatment. Despite recommendations for multidisciplinary management, diagnostic and treatment pathways are frequently fragmented.

This study evaluated the efficacy of a one-stop multidisciplinary clinic for CPIP in improving patient-reported outcomes (PROMS) and satisfaction.

A one-stop multidisciplinary clinic was established at the North Devon Comprehensive Hernia Centre, involving an Abdominal Wall Surgeon, Advanced Clinical Practitioners, Pain Management Consultants, and Pain Specialist Physiotherapists. Following a remote ACP assessment, patients underwent 45-minute evaluations by a surgeon, pain specialist, and physiotherapist, culminating in an MDT discussion and a personalized management plan. Data were retrospectively collected for patients reviewed between July 2021 and July 2022, including demographics, surgical history, CPIP diagnoses, treatments, and PROMS.

Forty patients underwent MDT assessment; 55% pursued further treatment. Among 19 patients with follow-up data, 26% underwent surgery, 35% invasive non-surgical treatments, and 39% pharmacological therapies combined with physiotherapy and psychological support. Pain scores (VAS) decreased from 7.2 to 2.8, and functional activity (mAAS) improved from 20.3 to 9.7 (p < 0.0001). Patient satisfaction was high (mean score: 4.5/5).

The one-stop multidisciplinary clinic significantly improved pain, function, and satisfaction, highlighting its value for CPIP management. Larger studies with delayed follow-up are needed to validate these findings.