Loos M J A, Roumen R M H, Scheltinga M R M
Department of Surgery, Máxima Medical Centre, PO Box 7777, De Run, 4600, Veldhoven, The Netherlands.
World J Surg. 2007 Sep;31(9):1760-1765. doi: 10.1007/s00268-007-9121-4.
Chronic post-herniorrhaphy pain is diverse in origin. The aim of our study was to classify post-herniorrhaphy pain syndromes following elective inguinal hernia repair.
All patients with an elective inguinal hernia repair performed between January 2000 and August 2005 received a questionnaire evaluating chronic inguinal pain (visual analog scale, VAS 0-10). Patients with moderate to severe pain complaints (VAS score >or= 3) were invited for an interview and an outpatient department physical examination.
A total of 2,164 cases underwent an elective hernia repair and received the questionnaire; 1,766 individuals responded (response rate: 81.6%). Moderate to severe pain was present in 211 patients (11.9%). Follow-up was performed in 148 patients. Three separate groups of diagnoses were identified. Group I: neuropathic pain (n = 72) indicating inguinal nerve damage; group II: non-neuropathic pain (n = 40) due to an array of diagnoses including periostitis (n = 18) and recurrent hernia (n = 13); and group III: a tender spermatic cord and/or a tight feeling in the lower abdomen (n = 43).
Chronic pain following elective hernia repair is common and diverse in etiology but may allow for a classification contributing to the development of tailored treatment regimens.
疝修补术后慢性疼痛的病因多种多样。我们研究的目的是对择期腹股沟疝修补术后的疼痛综合征进行分类。
2000年1月至2005年8月期间所有接受择期腹股沟疝修补术的患者均收到一份评估慢性腹股沟疼痛的问卷（视觉模拟评分法，VAS 0 - 10）。有中度至重度疼痛主诉（VAS评分≥3）的患者被邀请参加访谈和门诊体格检查。
共有2164例患者接受了择期疝修补术并收到问卷；1766人作出回应（回应率：81.6%）。211例患者（11.9%）存在中度至重度疼痛。对148例患者进行了随访。确定了三组不同的诊断。第一组：神经性疼痛（n = 72），提示腹股沟神经损伤；第二组：非神经性疼痛（n = 40），病因包括骨膜炎（n = 18）和复发性疝（n = 13）等一系列诊断；第三组：精索触痛和/或下腹部有紧绷感（n = 43）。
择期疝修补术后慢性疼痛很常见且病因多样，但可能可以进行分类，这有助于制定针对性的治疗方案。
