Psychological Disorders in Patients with Chronic Postoperative Inguinal Pain

Abstract

INTRODUCTION: Chronic postoperative inguinal pain (CPIP), a complication of inguinal hernia repair, may negatively affect mental health. The rate of psychological disorders in patients with CPIP is unknown. METHODS: A retrospective chart review was performed of all patients seen at the multidisciplinary chronic groin pain clinic at the Cleveland Clinic Foundation Center for Abdominal Core Health. This clinic is unique in that all patients are evaluated by a surgeon, a sonographer, and radiologist, and a behavioral psychologist. Patient psychological history and treatment, Depression Anxiety and Stress Scale (DASS) scores, pain catastrophizing, and trauma or abuse history were captured. RESULTS: From January 2018 to January 2022, 61 patients were evaluated and included in the study. Psychological treatment had been provided to 37 (61%) patients (present: 16 [27%], past: 21 [35%]). The most common psychological disorders represented were depression (n = 13, 22%), anxiety (n = 10, 17%), and post-traumatic stress disorder (n = 5, 8%). DASS scores indicated that 20 (33%) patients were experiencing symptoms of depression and 16 (27%) patients were experiencing symptoms of anxiety. Of the 40 patients assessed for pain catastrophizing, 28 (70%) reported rumination, 9 (23%) reported magnification, and 23 (58%) reported feelings of helplessness. A history of emotional or physical abuse or trauma was reported by 11 (18%) and 8 (13%) patients, respectively. CONCLUSION: A multidisciplinary groin pain clinic has revealed that patients with CPIP often have complex psychosocial issues, including mental illness, pain catastrophizing, and abuse history. A comprehensive multispecialty evaluation is critical for optimizing patient assessment and preoperative evaluation.