Factors predicting chronic pain after open mesh based inguinal hernia repair: ​A prospective cohort study

• 932 open mesh based hernia repairs were analyzed utilizing two regression models.
• Recurrence, complication, mesh weight, baseline VAS and age predict chronic pain.
• Recurrence, complication, mesh weight and baseline VAS predict intensity of pain.

IntroductionChronic postherniorrhaphy pain is the foremost setback of today's inguinal hernia repair. Finding predictors for it affects implants, operative techniques and allows for preventive measures.MethodsProspectively collected data from 932 outpatient open inguinal hernia operations between 2003 and 2010 were subjected to regression analysis. Visual analogue scale score (VAS) at least a year after operation and a measurement of chronic pain at one year were the target variables.ResultsChronic pain was present in 99 (11.5%) patients one year after operation. Independent predictors for the occurrence of chronic pain were positively recurrence (Odds ratio, OR 6.77 vs. no recurrence, P = 0.005), complication (OR 5.16 vs. no complication, P = 0.002), mid-density mesh (OR 2.28 vs. lightweight mesh, P = 0.012), higher preoperative VAS score (OR 1.15, P = 0.006) and negatively higher age (OR 0.98, P = 0.027).Predictors for a higher postoperative VAS score were recurrence (regression coefficient, RC, 1.49 vs. no recurrence, P = 0.001), complication (RC 0.76 vs. no complication, P = 0.016), heavyweight mesh (RC 0.50 vs. lightweight mesh, P = 0.046) and higher preoperative VAS level (RC 0.10, P < 0.001).ConclusionsRecurrence, complication, mesh weight, preoperative VAS score and age are predictors for the occurrence chronic pain after open mesh based inguinal hernia repair. Recurrence, complication, mesh weight and preoperative VAS score are predictors of postherniorrhaphy VAS level.