Chronic groin pain – Dr. Krpata – Cleveland Clinic
I just came across an interesting podcast, with a transcript, form the Cleveland Clinic. Dr. Krpata and the interviewer cover many of the main concerns about hernia repair. But I noticed that they did not really talk about how to avoid chronic groin pain. They came close, comparing recurrence rates, but did not state what seems obvious, that a pure tissue repair might be the best repair to start with. He also seems to imply that curing chronic groin pain is a certainty if it is recognized, when, of course, it’s not.
Anyway, it’s worth reading or listening to.
Here are some interesting statements from it. I think that study might have been about open mesh repairs. –
“How does somebody end up with chronic groin pain?
David Krpata: Yeah. One of the biggest areas that we focus on with chronic groin pain is after inguinal hernia repairs, and it’s actually a much higher than the risk of a hernia recurrence. So the hernia coming back after they get an inguinal hernia repair. And there’s probably multiple reasons for that, but there’s actually a really interesting study that they did in Sweden where they looked at 22,000 patients that had an inguinal hernia repair in one year. Afterwards, they asked them in the last week, rate your pain on a scale of one to seven. And right there in the middle at four they essentially described pain that impacted their ability to concentrate on a daily basis. And about 15% of people describe having that level of pain one year after an inguinal hernia.”
“Scott Steele: So what’s a final take home message for our listeners regarding chronic groin pain? And I guess the question that may jump out to others is: is it worth undergoing surgery up front?
David Krpata: Yeah, so I think I’ll take that second part first. So in terms of individuals deciding whether or not to get a hernia repair, the biggest thing I tell people is if you have a large hernia and it’s bothering you, you should get it fixed, because there are risks associated with that. You don’t want to end up with incarceration. If you have a small hernia and it doesn’t bother you, you can’t undergo something we call watchful waiting. But what we have learned is that if you observe those people over 10 years, it’s about a 60 to 70% chance that they will eventually get an operation because it will become symptomatic. So if you are feeling like you want to have an operation for your inguinal hernia, I still think it’s reasonable to do so.
Most important thing is to be aware of some of the complications after it, like chronic groin pain. And I think one of the biggest take home after all this for not only patients, but practitioners to acknowledge that chronic groin pain really does exist after inguinal hernia repairs. And the good news is we do have treatment options. So it’s not like if you get an operation and get chronic groin pain, you’re guaranteed to have it for the rest of your life.”
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