The true incidence is difficult to determine, pain having a subjective component. A prospective series of open Lichtenstein (419 patients) noted that at 1 year followup, 19% of patients had pain, 6% with moderate or severe degree. Predictors of moderate or severe pain included: recurrent hernia, high pain score at 1 week<unk> op, and high pain score at 4 weeks<unk> op. A Scottish population based study of 4062 patients identified at 3 months<unk> op an incidence of 43% mild pain and 3% severe or very severe pain. The severe and very severe group was associated with young age and female gender. A further survey of the 3% severe pain cohort (at a median of 30 months) found that 29% resolved, 39% improved and 26% continued with severe, or very severe pain. A followup of a randomized study of 750 laparoscopic vs. open hernia repair followed patients’ pain scores at 2 and 5 years<unk>  hernia repair via questionnaire. At 2 years, the chronic pain rate was 24.3% (lap) vs. 29.4% (open), and at 5 year follow up it was 18.1% (lap) vs. 20.1% (open). At 5 years, 4.3% in lap group and 3.7% in open group had attended a pain clinic. A larger and more recent study which was a followup at 5 years of 1370 from a randomized study of TEP vs. open repair demonstrated lower pain rates in the laparoscopic group (10% vs. 20%). Inguinodynia symptoms decreased over time, even in those in the moderate to severe pain group. In addition, when an inguinal pain questionnaire was administered to these individuals at a median followup of 9.4 years, physical ability was affected more in the open repair group. Predictors of chronic pain in the TEP group included Body Mass Index ≤ 3rd quartile (OR: 3.04), difference in preop and<unk> op physical testing (OR: 2.14) and time to full recovery exceeding the median (OR: 2.09). In the open group, the only association was noted with<unk> operative pain score exceeding the third quartile (OR: 1.89 ). Use of mesh-based repair vs. suture-based repair has also been discussed. Some results suggest less inguinodynia after Shouldice (suture) than Lichtenstein (open mesh) for young men. Other studies find equal results between Shouldice and laparoscopic TEP. The experience of the surgeon critically impacts the results, especially for Shouldice and laparoscopic repairs, which are fairly technical operations.
Post herniorraphy pain syndrome
Post-vasectomy pain syndrome
Descending perineum syndrome
Urologic chronic pelvic pain syndrome
Urethral syndrome
Pelvic congestion syndrome
PELVIS syndrome
Rectovaginal fistula