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Chronic pain after groin hernia repair: pain characteristics and impact on quality of life.
BMC Surg. 2020 Jul 06; 20(1):147.BS

Abstract

BACKGROUND

Chronic postsurgical pain (CPSP) after hernia repair research has mainly relied on unconfirmed self-reporting. We aimed to describe confirmed CPSP incidence, management, and quality of life (QoL) in a 2-year prospective study.

METHODS

Multicenter study (GENDOLCAT) of 3890 patients undergoing 4 common surgical procedures in 23 hospitals to develop a risk model for CPSP; 2352 men underwent open hernia repair. Patients with pain were identified by telephone at 1 and 3 months and referred to the hospital 4 months after surgery for a physical examination to confirm CPSP. Three validated tools were used: the Brief Pain Inventory (BPI) for severity, analgesic use, and interference with activities; the SF-12 questionnaire for QoL (validated Spanish version), and the Douleur Neuropathique 4 (DN4). Patients with CPSP were called again at 1 and 2 years.

RESULTS

In 1761 patients who underwent hernia repair and were eligible for physical examination for CPSP, the incidence of confirmed pain at 4 months was 13.6% (patient-reported pain, 6.2% at 1 year and 4.0% at 2 years). Neuropathic pain was diagnosed in 38.5% of the CPSP patients at 4 months. The incidences of neuropathic CPSP in patients with mesh or non-mesh repairs were similar (38.6 and 33.3%, respectively). SF-12 physical component scores changed little in all patients, whether or not they developed CPSP. The SF-12 mental component decreased significantly in all patients, but the decrease was clinically significant only in CPSP patients. CPSP interfered with activities (18%), work (15.6%), walking (15%) and mood (10.2%). At 2 years 52.1% of CPSP patients had moderate/intense pain and 28.2% took analgesics.

CONCLUSION

CPSP affects QoL-related activities, and although it diminishes over the course of 2 years after surgery, many patients continue to have moderate/intense pain and take analgesics. CPSP and neuropathic pain rates seem to be similar after mesh and non-mesh repair. BPI and SF-12 mental component scores detect effects on QoL.

TRIAL REGISTRATION

ClinicalTrials.gov NCT01510496.

Authors+Show Affiliations

Pain Clínic, Department of Anaesthesiology, Institut Municipal d'Investigació Médica. Parc de Salut Mar, Universitat Autònoma de Barcelona, Passeig Martím 25-29, 08003, Barcelona, Spain. dbande@parcdesalutmar.cat.Pain Clínic, Department of Anaesthesiology, Institut Municipal d'Investigació Médica. Parc de Salut Mar, Universitat Autònoma de Barcelona, Passeig Martím 25-29, 08003, Barcelona, Spain.General Surgery Department, Institut Municipal d'Investigació Médica. Parc de Salut Mar, Departament de Ciéncies Experimentals i de la Salut (CEXS), Universitat Pompeu Fabra, Barcelona, Spain.Pain Clínic, Department of Anaesthesiology, Institut Municipal d'Investigació Médica. Parc de Salut Mar, Universitat Autònoma de Barcelona, Passeig Martím 25-29, 08003, Barcelona, Spain.

Pub Type(s)

Journal Article
Multicenter Study

Language

eng

PubMed ID

32631293

Citation

Bande, David, et al. "Chronic Pain After Groin Hernia Repair: Pain Characteristics and Impact On Quality of Life." BMC Surgery, vol. 20, no. 1, 2020, p. 147.
Bande D, Moltó L, Pereira JA, et al. Chronic pain after groin hernia repair: pain characteristics and impact on quality of life. BMC Surg. 2020;20(1):147.
Bande, D., Moltó, L., Pereira, J. A., & Montes, A. (2020). Chronic pain after groin hernia repair: pain characteristics and impact on quality of life. BMC Surgery, 20(1), 147. https://doi.org/10.1186/s12893-020-00805-9
Bande D, et al. Chronic Pain After Groin Hernia Repair: Pain Characteristics and Impact On Quality of Life. BMC Surg. 2020 Jul 6;20(1):147. PubMed PMID: 32631293.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Chronic pain after groin hernia repair: pain characteristics and impact on quality of life. AU - Bande,David, AU - Moltó,Luis, AU - Pereira,Jose Antonio, AU - Montes,Antonio, Y1 - 2020/07/06/ PY - 2020/01/20/received PY - 2020/06/23/accepted PY - 2020/7/8/entrez PY - 2020/7/8/pubmed PY - 2020/7/14/medline KW - Chronic pain KW - Hernia repair KW - Quality o life SP - 147 EP - 147 JF - BMC surgery JO - BMC Surg VL - 20 IS - 1 N2 - BACKGROUND: Chronic postsurgical pain (CPSP) after hernia repair research has mainly relied on unconfirmed self-reporting. We aimed to describe confirmed CPSP incidence, management, and quality of life (QoL) in a 2-year prospective study. METHODS: Multicenter study (GENDOLCAT) of 3890 patients undergoing 4 common surgical procedures in 23 hospitals to develop a risk model for CPSP; 2352 men underwent open hernia repair. Patients with pain were identified by telephone at 1 and 3 months and referred to the hospital 4 months after surgery for a physical examination to confirm CPSP. Three validated tools were used: the Brief Pain Inventory (BPI) for severity, analgesic use, and interference with activities; the SF-12 questionnaire for QoL (validated Spanish version), and the Douleur Neuropathique 4 (DN4). Patients with CPSP were called again at 1 and 2 years. RESULTS: In 1761 patients who underwent hernia repair and were eligible for physical examination for CPSP, the incidence of confirmed pain at 4 months was 13.6% (patient-reported pain, 6.2% at 1 year and 4.0% at 2 years). Neuropathic pain was diagnosed in 38.5% of the CPSP patients at 4 months. The incidences of neuropathic CPSP in patients with mesh or non-mesh repairs were similar (38.6 and 33.3%, respectively). SF-12 physical component scores changed little in all patients, whether or not they developed CPSP. The SF-12 mental component decreased significantly in all patients, but the decrease was clinically significant only in CPSP patients. CPSP interfered with activities (18%), work (15.6%), walking (15%) and mood (10.2%). At 2 years 52.1% of CPSP patients had moderate/intense pain and 28.2% took analgesics. CONCLUSION: CPSP affects QoL-related activities, and although it diminishes over the course of 2 years after surgery, many patients continue to have moderate/intense pain and take analgesics. CPSP and neuropathic pain rates seem to be similar after mesh and non-mesh repair. BPI and SF-12 mental component scores detect effects on QoL. TRIAL REGISTRATION: ClinicalTrials.gov NCT01510496. SN - 1471-2482 UR - https://www.unboundmedicine.com/medline/citation/32631293/Chronic_pain_after_groin_hernia_repair:_pain_characteristics_and_impact_on_quality_of_life L2 - https://bmcsurg.biomedcentral.com/articles/10.1186/s12893-020-00805-9 DB - PRIME DP - Unbound Medicine ER -