Inguinodynia and inguinal hernia recurrence amongst Ugandan patients who underwent mesh versus non-mesh inguinal hernia repair

Abstract

Introduction: The prevalence of inguinal hernia recurrence dropped tremendously with the advent of mesh hernioplasty. However, the prevalence of inguinodynia has increased.

Objective: To determine and compare the prevalence of chronic postoperative inguinal pain (inguinodynia) and recurrence amongst patients who underwent mesh versus no mesh inguinal hernia repair in St. Francis Hospitals Nsambya and Naggalama in Uganda.

Method: This was a cohort retrospective study conducted at St Francis Hospitals Nsambya and Naggalama. The sample size was two hundred and two patients. A consecutive sampling technique with replacement of missing charts was used. The Principal Investigator and the research assistants then made telephone calls to the patients inviting them for an interview in the two hospitals, and for those who could not attend questionnaires were administered to them on phone. This was done sequentially until the sample size for each
hospital was reached. If a given telephone was not available or went unanswered, we telephoned the next patient in the sequence on the register. Inguinodynia was assessed using the Numerical Rating Pain Score (NPS). Recurrence was assessed by physical  examination.

Results: Two hundred and two patients were enrolled in the study. The prevalence of chronic postoperative inguinal pain amongst patients who underwent mesh versus non-mesh inguinal hernia repair were 24.4% and 8.5% respectively and the recurrence rates were 3.1% and 4.2% respectively.

Conclusion: The prevalence of chronic postoperative pain amongst patients who underwent hernioplasty was higher than those who underwent non-mesh inguinal hernia repair. There was statistically no difference in recurrence rates between patients who underwent mesh versus non-mesh inguinal hernia repair in both hospitals.

Key words: chronic postoperative inguinal pain, inguinodynia, hernioplasty, and numerical rating pain score