What to consider as clinicians about chronic postoperative pain and inguinal herniorrhaphy

Inguinal hernias account for 75% of all abdominal wall hernias, with a lifetime risk of 27% in men and 3% in women [1, 2]. The rate of repair of inguinal hernia ranges from 10 per 100,000 of the population in the United Kingdom to 28 per 100,000 in the United States [3]. Of these patients, chronic post-operative inguinal pain occurs in up to 54%. The persistence of postoperative inguinal herniorrhaphy pain for longer than 3 months following surgery has gained interest during the last years, becoming the most important outcome variable besides recurrence rates [4-6] because this pain affects and impairs activities of daily life in 12% of patients [7-10]. Indeed, pain-related sexual dysfunction, including dysejaculation, is now recognised to occur in at least 2% of young men [11]. Therefore, before surgery is considered for a benign disease, complications such as severe chronic pain, with its debilitating effects, must be carefully weighed against the benefits [12].