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Chronic Pain After Femoral Hernia Repair: A Cross-Sectional Study

Dahlstrand, Ursula MD*,§; Sandblom, Gabriel MD, PhD†,§; Nordin, Pär MD, PhD‡,¶; Wollert, Staffan MD, PhD*; Gunnarsson, Ulf MD, PhD†,§

doi: 10.1097/SLA.0b013e31822ba9b6
Original Articles

Objective: To explore the prevalence of and to identify possible risk factors for chronic pain after surgery for femoral hernia.

Background: Chronic pain has become a very important outcome in quality assessment of inguinal hernia surgery. There are no studies on the risk for chronic pain after femoral hernia surgery.

Methods: The Inguinal Pain Questionnaire was sent to 1967 patients who had had a repair for primary unilateral femoral hernia between January 1, 1997 and December 31, 2006. A follow-up period of at least 18 months was chosen. Answers from 1461 patients were matched with data recorded in the Swedish Hernia Register and analyzed.

Results: Some degree of pain during the previous week was reported by 24.2% (354) of patients. Pain interfered with daily activities in 5.5% (81) of patients. Emergency surgery (OR = 0.54; 95% CI = 0.40–0.74) and longer time since surgery (OR = 0.93; 95% CI = 0.89–0.98 for each year added) were associated with lower risk for chronic postoperative pain, whereas a high level of preoperative pain was associated with a higher risk for chronic pain (OR = 1.17; 95% CI = 1.10–1.25). Surgical technique was not found to influence the risk for chronic pain in multivariate logistic regression analysis.

Conclusions: Chronic postoperative pain is as important a complication after femoral hernia surgery as it is after inguinal hernia surgery. In contrast to inguinal hernia surgery, no risk factor related to surgical technique was found. Further investigations into the role of preoperative pain are necessary.

This study, using the Inguinal Pain Questionnaire, shows that chronic pain after femoral hernia repair is present in 24% and affects daily activities in 5.5% of patients. The occurrence of long-term pain is not associated to type of repair, but a high level of preoperative pain is a risk factor for chronic pain.

*Department for Surgical Sciences, Uppsala University, Uppsala, Sweden

CLINTEC, Karolinska Institute, Stockholm, Sweden

Department of Surgical and Perioperative Sciences, Umeå University, Sweden

§Gastro Center Surgery, Karolinska University Hospital, Stockholm, Sweden

Department of Surgery, Östersund Hospital, Östersund, Sweden.

Reprints: Ursula Dahlstrand, MD, Gastro Center Surgery, Karolinska University Hospital, 141 86 Stockholm, Sweden. E-mail:

Disclosure: Supported, in part, through grants by the Uppsala-Örebro Regional Research Council. The Swedish Hernia Register is financially supported by the National Board of Health and Welfare and by the Swedish Association of Local Authorities and Regions and by the participating surgical units. Authors declare no conflicts of interests.

© 2011 Lippincott Williams & Wilkins, Inc.