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Is Postoperative Chronic Pain Syndrome Higher with Mesh Repair of Inguinal Hernia?

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The American surgeon. Am Surg. 2010 Oct;76(10):1115-8

KRISTIN MASUKAWA, B.A., SAMUEL E. WILSON, M.D.
From the Long Beach Veterans Affairs Medical Center, Long Beach, California

Abstract

Chronic postoperative pain has been associated with mesh repair in meta-analysis of clinical trials. We compared the incidence of early complications, recurrence, and chronic pain syndrome in anatomic and mesh repairs in 200 patients. We defined chronic pain syndrome as pain in the inguinal area more than 3 months after inguinal hernia repair, patient referral to pain management, or necessity of a secondary procedure for pain control. The mean follow-up time was 4 years and 2 months for anatomic repair and 3 years and 7 months for mesh repair. The clinical outcomes did not reveal a significant disparity between the 100 consecutive patients who had mesh repair versus the 100 patients who had anatomic repair with regard to the incidence of superficial wound infection (0 vs. 2%, P 5 0.497), testicular swelling (12 vs. 7%, P 5 0.335), hematoma (1 vs. 0%, P 5 0.99), recurrence (3 vs. 2%, P 5 0.99), or chronic postoperative pain (4 vs. 1%, P 5 0.369). The anatomic procedure without mesh should continue to be offered to patients who have an initial inguinal hernia repair.