Chronic pain and quality of life following open inguinal hernia repair

Background: The aim was to determine the frequency and characteristics of chronic pain following open inguinal hernia repair and to identify risk factors for its development. Methods: This was a questionnaire survey of a historical cohort of patients who underwent inguinal hernia surgery in Aberdeen. The sample comprised all patients (n = 351) who underwent surgery between January 1995 and December 1997, and who were alive and resident in Grampian in October 1999. Outcome measures included self-report of pain persisting for more than 3 months after operation. Pain was characterized by means of the McGill Pain Questionnaire, and quality of life was assessed with the Short Form 36 (SF-36). Results: A total of 226 patients (64 per cent) completed the questionnaire, 67 (30 per cent) of whom reported chronic pain. Reported pain was predominantly neuropathic in character. Patients at increased risk of chronic pain were under 40 years old (P < 0.001), had day-case surgery (P = 0.004), had subsequent surgery on the same side (P < 0.005) and recalled pain before operation (P = 0.005). The SF-36 scores were significantly different in the social functioning, mental health and pain dimensions in patients with chronic pain. Conclusion: Chronic pain occurred in 30 per cent of patients after open hernia repair, a higher frequency than has been reported previously. Several risk factors were identified and further prospective research is recommended.