Abstract
BackgroundChronic pain as a complication following inguinal herniorrhaphy has attracted increasing attention in recent years. There is evidence that the chronic pain seriously affects patients’ quality of life. However, there are few imaging studies and diagnostic techniques of the chronic pain. The aim of this study is to explore the etiology and to analysis ultrasonographic imaging description of chronic pain following anterior open inguinal herniorrhaphy.MethodsOne hundred fifty two patients with the chronic pain following anterior open inguinal herniorrhaphy were performed by ultrasonography to identify the main causes of postoperative chronic pain. Positive ultrasonic diagnoses were confirmed to be correct by the pain relieved when the patients underwent re-operation and other clinical operations. Positive diagnoses which appeared simultaneously were grouped for pairwise comparisons.ResultsTwo hundred sixteen positive ultrasonic diagnoses, 12 categories of postoperative chronic pain were found. They were encapsulated effusion, scrotal wall edema, testitis, hydrocele testis, restricted motion of spermatic cord at the reconstructed deep inguinal ring, varicocele, scar sutured into pubic tubercle, shrinking mesh, accumulational mesh or mesh plug, recurrent hernia, cyst of spermatic cord and epididymal cyst. In the pairwise comparison groups, encapsulated effusion with scrotal wall edema, varicocele with restricted motion of spermatic cord at the reconstructed deep inguinal ring, and shrinking mesh with recurrent hernia had significant differences in each intragroup comparisons(P < 0.05).ConclusionsUltrasonography provieds important value in the diagnosis of chronic pain following anterior open inguinal herniorrhaphy. Some positive diagnoses occur simultaneously, which is necessary for doctors to consider comprehensively.
Highlights
Chronic pain as a complication following inguinal herniorrhaphy has attracted increasing attention in recent years
There appeared to be restricted motion of the spermatic cord at the reconstructed deep inguinal ring in 20 cases(9.2%)(Fig. 7), including 10 cases of the spermatic cord adhered in the deep inguinal ring, 7 cases of patch compression of the spermatic cord, and 3 cases of reconstructed deep inguinal ring stenosis, all of which were confirmed by adhesiolysis and inguinal neurotomy
Ultrasonic diagnosis of chronic pain sites following anterior open inguinal herniorrhaphy Among 164 chronic pain sites, 121 sites showed positive findings on ultrasonography and no ultrasonic abnormality was found in 43 sites
Summary
Chronic pain as a complication following inguinal herniorrhaphy has attracted increasing attention in recent years. The aim of this study is to explore the etiology and to analysis ultrasonographic imaging description of chronic pain following anterior open inguinal herniorrhaphy. It was pointed out in Guidelines for diagnosis and treatment of adult inguinal hernia (2014 edition) [ 1] that almost all cases of inguinal hernia are treated surgically, and anterior open inguinal herniorrhaphy is considered to be the most common surgical procedure. The aim of our study was to explore the etiology and analyze positive findings of chronic pain after anterior open inguinal herniorrhaphy, thereby to assist in making treatment protocols in clinics In the 1980s, the chronic pain was reported [2,3,4] to be a rare and occasional postoperative complication, and the
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