When you have surgery to repair a painful inguinal hernia (where soft tissue bulges through a weak part of your abdominal wall) you likely expect the surgery to relieve your pain. It does for most people, but for others groin pain may last for months — or even years — after surgery.
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Inguinal hernia repair is common. It accounts for about 800,000 surgeries performed in the U.S. each year. And most patients feel better by a few weeks after surgery.
However, some patients end up with chronic groin pain. It can last for months and is sometimes quite debilitating. It may even interfere with sitting or walking, says general surgeon David Krpata, MD.
We talked with Dr. Krpata to better understand the possible cause of post-surgery chronic pain — pain that lasts for three months and the best options for relief.
Post hernia-repair pain: Why it happens
You may have had open surgery to repair your hernia, in which an incision is made in your abdomen. Or the surgeon may have made the repair laparoscopically — with a tiny, telescope-like device inserted through small incisions.
Either way, it’s likely your surgeon used synthetic mesh to reinforce your abdominal wall, Dr. Krpata says.
Most often, he says, one of two issues causes pain following hernia repair surgery:
- Reaction to the mesh itself. Sometimes the mesh used in hernia repair can cause inflammation or irritation leading to pain. This may happen because your body recognizes the mesh as a foreign object or the mesh rubs against muscles or nerves, causing irritation.
- Nerve disturbance. There are three major nerves that run through the abdominal area, Dr. Krpata says. If one of the nerves gets caught in a suture or the mesh, chronic pain can result.
What are your options for relief?
If you had surgery to repair a hernia and are still having pain after three months, it’s time to talk with your surgeon, Dr. Krpata says.
Your surgeon should consider all possible treatment options to determine which is best for relieving your pain. Options may include:
- Mesh removal — surgical removal of the abdominal mesh.
- Neurectomy — surgical removal of a nerve or part of a nerve.
- PRP injections — injection of a plasma-rich protein complex to promote healing and ease nerve pain.
- Nerve ablation — a minimally invasive procedure that uses electrical currents to dampen nerve pain.
- Pain management through medication or anesthetic injections.
“While injections, nerve ablation and medication can help ease pain, they don’t do much to help the underlying issue,” Dr. Krpata says.
Get a second opinion, if necessary
Don’t assume you just have to live with the pain, Dr. Krpata says.
“We see patients with chronic pain after hernia repair surgery and often the option to have additional surgery isn’t even presented to them,” he says. “While additional surgery isn’t the right choice for everyone, for some, mesh removal or neurectomy procedures can provide significant or complete relief from chronic pain.”
Ultimately, a multidisciplinary team approach, in collaboration with pain management, is required to determine which treatment options patients may respond to, Dr. Krpata says.
If you have talked with your surgeon about your options for relief from chronic pain, but aren’t getting relief, it may be time to think about choosing a specialist, Dr. Krpata says.
