Chronic Groin Pain After Hernia Surgery: What Are We Missing?

Area of Science:

• Surgical outcomes
• Pain management
• Hernia repair complications

Background:

• Chronic postoperative inguinal pain (CPIP) is a frequent complication of inguinal hernia repair.
• Mesh techniques reduce recurrence but increase focus on postoperative pain.
• Understanding CPIP is vital for improving patient recovery and quality of life.

Purpose of the Study:

• To review the international literature on CPIP.
• To analyze factors influencing CPIP incidence, including surgical techniques and geographic variations.
• To explore the distinction between neuropathic and nociceptive pain in CPIP.

Main Methods:

• Narrative review of international studies on CPIP.
• Selection criteria included relevance, sample size, and pain subclassification.
• Analysis of data on incidence, surgical approach, and pain type.

Main Results:

• CPIP incidence ranges from 6% to 64.3%, affected by follow-up duration and surgical approach.
• Open hernia repair is linked to higher CPIP rates than laparoscopic methods.
• Neuropathic pain is common in specific groups, yet pain subclassification is often lacking.

Conclusions:

• CPIP is multifactorial and often under-recognized in clinical practice.
• Standardized diagnostic tools and long-term follow-up are needed for better pain classification and management.
• A structured diagnostic algorithm can aid in distinguishing pain types and tailoring treatments.