Reply To: The best strategy for the management of inguinodynia is prevention

[MarkT]

Slight clarification to above…it covers 953 hernias in 874 patients.

Statistically significant predictors of inguinodynia were younger age (54 vs. 61yr old), smoker at time of operation, history of prior contralateral repair, and postoperative complication.

Cumulative post-op problems were 11.9% (urinary retention, post-op pain that is not chronic, seroma, site bleeding, etc)…and 12 had inguinodynia, 10 had recurrences.

There is a lot more to the study, including some discussion of inguinodynia…he cites the low rate here as perhaps due to “1) a standardized technique with division of the inguinal nerve when encountered; (2) an almost exclusive male cohort of patients; (3) an older patient population; and (4) the retrospective nature of our study and not a true reflection of the actual rate.”

“It is unclear if dividing the ilioinguinal nerve reduces the rate of inguinodynia. Three randomized trials have addressed inguinal neuronectomy to prevent inguinodyania. Two had favorable results, and one argued against it.”