POSTHERNIORAPHIC ILIOINGUINAL PAIN SYNDROME: A MULTIDISCIPLINARY APPROACH TO THE PROBLEM
DOI:
https://doi.org/10.32782/2226-2008-2023-2-12Keywords:
inguinal hernia, chronic pain, inguinodynia, multidisciplinary approachAbstract
The aim of the study was to assess the prevalence of pain syndrome in patients with recurrent inguinal hernias. Material and methods. The research was carried out on the basis of the regional clinical hospital (Odesa) in 2013–2022. 152 cases of recurrent inguinal hernias were analyzed. In 34 (22.4%) cases, hernia relapses occurred after autoplasty, 82 (53.9%) – after Lichtenschein hernioplasty. Another 36 (23.7%) had recurrence of inguinal hernia after laparoscopic hernioplasty. The sample was dominated by men (144 or 94.7%). The patients’ quality of life was assessed using the EURAHS-QoL scale. Additionally, the pain syndrome was assessed using the modified Inguinal Pain Questionnaire (IPQ) scale. Statistical processing of the obtained data was carried out by the method of variance analysis using the Statistica 14.0 software (TIBCO, USA). The results. Chronic pain syndrome occurred in 83 (54.6%) patients operated on for inguinal hernias. At the same time, the highest frequency of chronic pain was after open autoplasty (31 cases out of 34 or 91.2%). After Lichtenstein’s hernioplasty, the frequency of chronic pain after inguinal hernia repair was 47 cases out of 82 or 57.3%. Chronic pain occurred much less often after laparoscopic hernioplasty, but overall its frequency exceeded 10% (5 out of 36 or 13.9%). Signs of damage to the ilio-inguinal (47.0%) and ilio-femoral (39.8%) nerves were most common. The intensity of the pain syndrome averaged 4.9±0.3 points. According to EURAHS-QoL, pain intensity at rest was 3.2±0.3 points, during usual activity it was 4.7±0.3 points. Patients rated the most intense pain in the last week at the level of 6.6±0.5 points. Patients with postherniorrhagic pain syndrome assessed the impact on daytime activity at home at the level of 5.3±0.3 points, on usual activity outside the home - 6.1±0.4 points, during physical exercises and sports - 7.2±0 .5 points, with heavy physical work - 7.4±0.6 points. A pronounced neuropathic component of pain was noted in 29 (34.9%) patients. Funiculodynia occurred in 12 (7.9%) cases.
The article is available at the Institutional Repository of Odesa National Medical University http://journal.odmu.edu.ua/?p=7597&lang=en
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