Associate Professor Urmas Lepner, University of Tartu
Professor of Surgery Hannu Paajanen, University of Eastern Finland
After the widely used alloplasty in inguinal hernia surgery, the most common complications are chronic pain and foreign body feeling, which can have a major influence on patients' quality of life.
The aims of this study were to evaluate the rate of chronic pain and foreign body feeling after open inguinal hernia repair in case of using different meshes and to clarify which mesh parameters have a significant influence on development of chronic symptoms. Furthermore, the aim was to evaluate patients' quality of life after inguinal hernia repair.
Up to 59.4 % of patients reported having experienced pain during different activities at 6-month follow-up. The feeling of a foreign body in the inguinal region was experienced by up to 47.8 % of patients. According to our studies, the weight, pore size and suture fixation of a mesh do not have a significant impact on development of chronic pain. Considering the high rate of early severe postoperative pain and the association between early severe pain and development of chronic pain, a better postoperative pain control strategy is needed. Significantly less patients experienced pain during different activities at three-year follow-up compared to the results of 6-month follow-up. Therefore, if surgical treatment of chronic pain is considered, it should be postponed for more than one year after the primary operation. In asymptomatic cases postponement of hernia repair until development of complaints should be considered due to the high rate of chronic postoperative pain.
Improvement in quality of life scores after inguinal hernia surgery indicates the importance of prompt elective repair of symptomatic inguinal hernias and demonstrates that inguinal hernias have a greater influence on quality of life than is generally thought.
Regarding the high rate of chronic pain after inguinal hernia repair, other mesh parameters, paritcularly, their combinations should be explored.