Outcome of patients with severe chronic pain following repair of groin hernia

Background: Chronic pain is the most serious long-term complication that can occur after repair of a groin hernia. The aim of this study was to assess the outcome of patients who report severe or very severe pain 3 months after groin hernia repair. Methods: This was a population-based study of all patients who underwent repair of a groin hernia between April 1998 and March 1999 in Scotland. All received a postal questionnaire 3 months after hernia repair and those who reported severe or very severe pain at the operation site were asked to complete a further questionnaire 2.5 years later. The main outcome measure included the number of patients with persistent pain and the effect of pain on daily activities and quality of life. Results: Of 5506 patients who underwent repair of a groin hernia, 4062 (74 per cent) returned the first questionnaire and 125 (3 per cent) reported severe or very severe pain. Eight-six (72 per cent) of 120 patients (five had died or could not be contacted at the original address) replied to the second questionnaire; 61 (71 per cent) still reported pain, which was severe or very severe pain in 22 (26 per cent) and mild or very mild in 39 (45 per cent). Twenty-nine (48 per cent) sought further medical help from their general practitioner or surgeon. Nine (15 per cent) attended a pain clinic while five (8 per cent) had further surgery. Chronic pain had significant effects (P < 0.001) on all daily activities including walking, work, sleep, relationships with other people, mood and general enjoyment of life. Conclusion: Chronic pain persists in most patients who report severe or very severe pain at 3 months after hernia repair, and has a significant effect on the patients' daily activities and quality of life.