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Surg Endosc. 2018 Apr;32(4):1971-1983. doi: 10.1007/s00464-017-5893-2. Epub 2017 Oct 26.

What are the influencing factors for chronic pain following TAPP inguinal hernia repair: an analysis of 20,004 patients from the Herniamed Registry.

Author information

1
Hanse-Hernia Center, Alte Holstenstrasse 16, 21031, Hamburg, Germany.
2
StatConsult GmbH, Halberstädter Strasse 40 a, 39112, Magdeburg, Germany.
3
Department of Surgery, Paracelsus Medical University, Müllner Hauptstrasse 48, 5020, Salzburg, Austria.
4
Department of General, Visceral and Oncologic Surgery, Wilhelminen Hospital, Montleartstrasse 37, 1160, Vienna, Austria.
5
Winghofer Medicum, Hernia Center, Winghofer Strasse 42, 72108, Rottenburg am Neckar, Germany.
6
Department of Surgery and Center for Minimally Invasive Surgery, Academic Teaching Hospital of Charité Medical School, Vivantes Hospital, Neue Bergstrasse 6, 13585, Berlin, Germany.
7
Department of Surgery and Center for Minimally Invasive Surgery, Academic Teaching Hospital of Charité Medical School, Vivantes Hospital, Neue Bergstrasse 6, 13585, Berlin, Germany. ferdinand.koeckerling@vivantes.de.

Abstract

BACKGROUND:

In inguinal hernia repair, chronic pain must be expected in 10-12% of cases. Around one-quarter of patients (2-4%) experience severe pain requiring treatment. The risk factors for chronic pain reported in the literature include young age, female gender, perioperative pain, postoperative pain, recurrent hernia, open hernia repair, perioperative complications, and penetrating mesh fixation. This present analysis of data from the Herniamed Hernia Registry now investigates the influencing factors for chronic pain in male patients after primary, unilateral inguinal hernia repair in TAPP technique.

METHODS:

In total, 20,004 patients from the Herniamed Hernia Registry were included in uni- and multivariable analyses. For all patients, 1-year follow-up data were available.

RESULTS:

Multivariable analysis revealed that onset of pain at rest, on exertion, and requiring treatment was highly significantly influenced, in each case, by younger age (p < 0.001), preoperative pain (p < 0.001), smaller hernia defect (p < 0.001), and higher BMI (p < 0.001). Other influencing factors were postoperative complications (pain at rest p = 0.004 and pain on exertion p = 0.023) and penetrating compared with glue mesh fixation techniques (pain on exertion p = 0.037).

CONCLUSIONS:

The indication for inguinal hernia surgery should be very carefully considered in a young patient with a small hernia and preoperative pain.

KEYWORDS:

Chronic pain; Complications; Hernia registry; Inguinal hernia; TAPP

PMID:
29075969
PMCID:
PMC5845068
DOI:
10.1007/s00464-017-5893-2
[Indexed for MEDLINE]
Free PMC Article

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