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Post herniorrhaphy pain syndrome, or inguinodynia is pain or discomfort lasting greater than 3 months after surgery of inguinal hernia. Randomized trials of laparoscopic vs open inguinal hernia repair have demonstrated similar recurrence rates with the use of mesh and have identified that chronic groin pain (>10%) surpasses recurrence (<2%) and is an important measure of success.
Inguinal hernia surgery is an operation to repair a weakness in the abdominal wall that abnormally allows abdominal contents to slip into a narrow tube called the inguinal canal in the groin region. There are two different clusters of hernia: groin and ventral (abdominal) wall. Groin hernia includes femoral, obturator, and inguinal. [1]
In the event of a mesh rejection, the mesh will very likely need to be removed. Mesh rejection can be detected by obvious, sometimes localized swelling and pain around the mesh area. Continuous discharge from the scar is likely for a while after the mesh has been removed. A surgically treated hernia can lead to complications such as inguinodynia.
Postoperative pain is usually experienced at pelvic, groin, thigh region or during sexual intercourse. Furthermore, it can be caused by mesh erosion or subclinical infection. [3] [4] One hypothesised aetiology for mesh-related pain is that inflammatory response induces the shrinkage of mesh, leading to vaginal tightening. [3] [4] [22] [23]
Clinically, incisional hernias present as a bulge or protrusion at or near the area of a surgical incision. Virtually any prior abdominal operation can develop an incisional hernia at the scar area (provided adequate healing does not occur due to infection), including large abdominal procedures such as intestinal or vascular surgery, and small incisions, such as appendix removal or abdominal ...
Nausea, vomiting, and severe abdominal pain are characteristics of a strangulated hernia. This is a medical emergency, as the loss of blood supply to the bowel can result in necrosis (tissue death) followed by gangrene (tissue decay). This is a life-threatening condition requiring immediate surgery. [3]
Transvaginal mesh (TVM) has a greater risk of bladder injury and of needing repeat surgery for stress urinary incontinence or mesh exposure. [17] The use of a TVM in treating vaginal prolapses is associated with severe side effects including organ perforation, infection, and pain. Safety and efficacy of many newer meshes is unknown. [16]
Pain is usually felt low down over the symphyseal joint, and this area may be extremely tender to the touch. Pain may also be felt in the hips, groin and lower abdomen and can radiate down the inner thighs. Women with PGP may begin to waddle or shuffle, and may be aware of an audible clicking sound coming from the pelvis.