Chronic Groin Pain Following Anterior Hernia Surgery

Inguinal herniorrhaphy is one of the most common general surgery operations performed in the United States with nearly 600,000 repairs annually. An anterior approach is the most common method for surgical repair, which may be performed as either a tissue repair or tension-free mesh repair. While recurrence rates are lower with tension-free repairs, long-term neuralgia is a feared complication. Chronic post-herniorrhaphy groin pain is defined as pain lasting >3 months following hernia repair. Studies show an incidence of chronic pain of 11 %. Treatments for chronic groin pain include nonoperative interventions such as pain control with or without narcotic pain medications, and injection-based therapies such as nerve blocks and radiofrequency neurolysis. Additionally, operative intervention has been used for refractory chronic groin pain. Surgical treatments include single nerve resection, triple neurectomy, and mesh removal.