Iatrogenic chronic pain is a neglected problem that may totally annul the benefits from hernia repair.
Dr Ulf Fränneby and colleagues estimated the prevalence of residual pain 2 to 3 years after hernia surgery.
The research team identified factors associated with its occurrence, and assessed the consequences for the patient.
The team included a sample of 3000 of 9280 patients from the population-based Swedish Hernia Register aged 15 to 85 years.
The patients were registered as having undergone a primary groin hernia operation in the year 2000.
|Pain interfered with daily activities in 6%|
|Annals of Surgery|
Of these, the 2853 patients still alive in 2003 were requested to fill in a postal questionnaire.
After 2 reminders, 2456 patients, 2299 men and 157 women responded.
In response to a question about ‘worst perceived pain last week', 31% reported pain to some extent.
The researchers found that in 6%, the pain interfered with daily activities.
Age below median, a high level of pain before the operation, and occurrence of any postoperative complication were found to independently predict long-term pain.
The team noted that the same variables predicted long-term pain with ‘pain right now' as outcome variables.
The researchers observed that a repair technique using anterior approach, predicted long-term pain with ‘pain right now' as outcome variables.
Dr Fränneby's team concludes, “Pain that is at least partly disabling appears to occur more often than recurrences.”
“The prevalence of long-term pain can be reduced by preventing postoperative complications.”
“The impact of repair technique on the risk of long-term pain shown in our study should be further assessed in randomized controlled trials.”