Vol.:(0123456789) 1 3 Surgery Today https://doi.org/10.1007/s00595-018-1664-5 ORIGINAL ARTICLE Decreasing prevalence of chronic pain after laparoscopic groin hernia repair: a nationwide cross-sectional questionnaire study Stina Öberg 1  · Kristofer Andresen 1  · Jacob Rosenberg 1 Received: 15 December 2017 / Accepted: 13 March 2018 © Springer Nature Singapore Pte Ltd. 2018 Abstract Purpose Up to 6–7% of patients who have undergone laparoscopic groin hernia repair sufer from chronic pain, depending on various factors; however, the long-term course is unclear. The purpose of this study was to assess the prevalence of chronic pain 1–5 years after laparoscopic groin hernia repair. Methods The subjects of this nationwide cross-sectional questionnaire study were adults who underwent laparoscopic mesh repair of an inguinal or a femoral hernia. The patients were identifed from the Danish Hernia Database, which has a follow-up rate of almost 100%. The prevalence of chronic pain was assessed 1–5 years postoperatively by the validated inguinal pain questionnaire (IPQ). Results A total of 1383 groins were included in this study, based on a 66% response rate to the questionnaire. The preva- lence of pain decreased, especially 3.5 years postoperatively. There were no statistically signifcant diferences when each postoperative year was compared with the second postoperative year. However, the prevalence of chronic pain 3.5–5 years postoperatively was signifcantly lower (4.4%) than that 1–3.5 years postoperatively (8.1%) (p = 0.014). The prevalence of pain that could not be ignored was still 5–6% in the ffth postoperative year. Conclusions The prevalence of chronic pain seems to decline 1–5 years after laparoscopic groin hernia repair, with a distinct decrease 3.5 years postoperatively. Keywords Groin hernia · Inguinal hernia · Chronic pain · Laparoscopy · Inguinal pain questionnaire (IPQ) Introduction Groin hernias are comprised of inguinal and femoral hernias [1], with inguinal hernias being the most common in both sexes [2]. The lifetime incidence of an inguinal hernia is 27% in men and 3% in women [3], resulting in more than 20 mil- lion repairs annually worldwide [4]. Chronic pain after groin hernia surgery compromises the patients’ quality of life [5] and severe pain can be devastating [6]. Chronic pain is defned as pain persisting for more than 6 months postop- eratively [7]. About 10–12% of patients sufer chronic pain after a groin hernia repair [8–11], but studies report a wide range because of the various defnitions of chronic pain. When subdividing pain according to the type of surgery, 6–7% sufer chronic pain after laparoscopic inguinal hernia repair [9, 12]. Pain decreases over time, but the precise time course is unclear [9]. The European Hernia Society (EHS) stated that laparoscopic inguinal hernia repairs have a lower risk of chronic pain than the Lichtenstein repair [13]. How- ever, this statement is based partly on a meta-analysis that lacks a defnition of chronic pain [14]. Moreover, the EHS guideline stated that the observed diference seems to equal- ize after more than 3–4 years postoperatively [13]. The present study provides cross-sectional data on the prevalence of chronic pain at diferent times after laparo- scopic groin hernia repair. The primary aim was to assess if the prevalence of pain declined during the follow-up or if there was a steady low prevalence of chronic pain. The sec- ondary aim was to compare the prevalence of chronic pain before and after 3–4 years, based on the EHS statement [13]. * Stina Öberg stina.oeberg@gmail.com 1 Center for Perioperative Optimization, Department of Surgery, Herlev Hospital, University of Copenhagen, Herlev, Denmark