Predictors of chronic pain after laparoscopic inguinal hernia repair

Surgery. 2021 Mar;169(3):586-594. doi: 10.1016/j.surg.2020.07.049. Epub 2020 Sep 26.

Abstract

Background: Multiple studies have analyzed predictors for chronic pain after open hernia repair. The purpose of this study is to determine which factors predict the development of chronic pain after a laparoscopic inguinal hernia repair.

Methods: We identified patients who underwent laparoscopic inguinal hernia repair between 2008 and 2020 at a single institution. Quality of life was measured using the Surgical Outcomes Measurement System and Carolinas Comfort Scale. We categorized patients with chronic pain if their score on Carolinas Comfort Scale was greater than or equal to 3. Multivariable logistic regression analysis was used to identify predictors of chronic pain.

Results: A total of 960 patients met inclusion criteria. Mean age was 59 (± 14, standard deviation) years, 89 (9.3%) of whom were female. Six percent of patients met criteria for chronic pain (Carolinas Comfort Scale ≥3). On multivariable analysis, predictors for chronic pain were age 45 (P < .001), female sex (P = .006), preoperative pain visual analog scale ≥1 (P = .025), prior inguinal hernia repair (P = .045), higher American Society of Anesthesiologists class (P = .041), use of multifilament polyester mesh (P = .0448), and intraoperative placement of a urinary catheter (P = .009).

Conclusion: Laparoscopic inguinal hernia repair results in 6.0% of patients experiencing chronic pain. We identified multiple predictors for chronic pain.

MeSH terms

  • Adult
  • Aged
  • Chronic Pain / diagnosis*
  • Chronic Pain / epidemiology
  • Chronic Pain / etiology*
  • Clinical Competence
  • Female
  • Hernia, Inguinal / complications*
  • Hernia, Inguinal / surgery*
  • Humans
  • Laparoscopy* / methods
  • Male
  • Middle Aged
  • Pain Measurement
  • Pain, Postoperative / diagnosis*
  • Pain, Postoperative / epidemiology
  • Pain, Postoperative / etiology*
  • Postoperative Care
  • Preoperative Care
  • Prognosis
  • Quality of Life
  • Treatment Outcome