Prevalence and severity of chronic groin pain after endoscopic totally extraperitoneal inguinal hernioplasty

Background: Chronic groin pain after open inguinal hernia repair is a common long-term morbidity, but its incidence after endoscopic totally extraperitoneal inguinal hernioplasty (TEP) has not been studied in detail. The objective of this study was to evaluate the prevalence and severity of chronic groin pain after TEP. Methods: Between June 1999 and September 2001, 313 consecutive patients who underwent TEP at our institution were recruited. To evaluate the incidence and severity of chronic pain, a cross-sectional telephone survey using a standardized questionnaire was conducted by a research assistant. Clinical data between the chronic pain group and the pain-free group were compared to identify any clinical factors that had a significant association with the subsequent development of chronic groin pain. Results: The prevalence of chronic groin pain was 9.2% (n = 24). The severity of the pain was mild (n = 18), moderate (n = 5), or severe (n = 1). In more than half of the patients, the groin pain occurred less often than once a month and its duration did not exceed 1 min. Only one patient reported an impairment of functional activities as a result of the pain. Multivariate analyses identified a significant association between a high postoperative pain score on coughing on postoperative day 6 and the subsequent development of groin pain. Conclusions: The prevalence of chronic groin pain in patients after TEP was low. The pain was mostly mild and transient without associated sensory symptoms. The occurrence of pain had a negligible impact on daily activities.