Abstract
Background
In groin hernia repair studies, chronic pain is a frequently used primary endpoint. However, its impact on daily life activities has been less investigated. Such an outcome is relevant for the patient and surgeon and cannot be extrapolated out of pain scores. The Pain Disability Index (PDI), a questionnaire wherein patients rate their impairment, could reveal the consequences of pain. The PDI was therefore introduced in a trial upon open mesh-based inguinal hernia repair.
Methods
A total of 172 patients received an open preperitoneal repair or Lichtenstein procedure. Primary endpoints for this report were the PDI scores measured preoperatively, after 2 weeks and 3 months. The Visual Analogue Scale pain (VAS) scores were assessed simultaneously. Chronic pain was defined as any VAS score at 3 months postoperatively.
Results
The PDI scores of all measure moments were available for 146 patients (85%). A correlation between the PDI and VAS score was found at all moments (P < 0.001). A total of 47 patients reported chronic pain. The intensity of their pain correlated more significantly with the PDI than VAS scores at 2 weeks postoperatively (R = 0.286, P<0.001 vs. R = 0.175, P = 0.036). Thirty chronic pain patients reported restrictions. The main disabilities were for the recreation, occupation and sexual subscale. Their PDI scores were not influenced whether work was rated as light or heavy (P = 0.570). Twelve patients without chronic pain reported impairment in daily life (mean PDI score 8.8 ± 10.8).
Conclusion
The PDI is feasible in inguinal hernia repair and can be used as an adjuvant in pain measurement. It can identify patients still suffering postoperatively who might otherwise be missed. Furthermore, the PDI could serve as a predictor for chronic pain.
Similar content being viewed by others
References
Poobalan AS, Bruce J, Crains W, Smith S, King PM, Krukowski ZH, Chambers WA (2003) A review of chronic pain after inguinal herniorrhaphy. Clin J Pain 19:48–54
Poobalan AS, Bruce J, King PM, Chambers WA, Krukowski ZH, Smith WCS (2001) Pain following hernia repair. Br J Surg 88:1122–1126
Callessen T, Bech K, Kehlet H (1999) Prospective study of chronic pain after groin hernia repair. Br J Surg 86:1528–1531
Aasvang E, Kehlet H (2005) Chronic postoperative pain: the case of inguinal herniorrhaphy. Br J Anaesth 95:69–76
Pollard CA (1984) Preliminary validity study of pain disability index. Percept Mot Skills 59:974
Tait RC, Pollard CA, Margolis RB, Duckro PN, Krause SJ (1987) The pain disability index: physometric and validity data. Arch Phys Med Rehabil 68:438–441
Tait RC, Chibnall JT, Krause SJ (1990) The pain disability index: psychometric properties. Pain 40:171–182
Gronblad M, Hupli M,Wennerstrand P, Jarvinen E, Lukinmaa A, Kouri JP, Karaharju EO (1993) Intercorrelation and test–retest reliability of the pain disability index (PDI) and the Owestry disability questionnaire (ODQ) and their correlation with pain intensity in low back pain patients. Clin J Pain 9:189–195
Tait RC, Chibnall JT (2005) Factor structure of the pain disability index in workers’ compensation claimants with low back injuries. Arch Phys Med Rehabil 86:1141–1146
Nienhuijs SW, Staal JF, Keemers-Gels ME, Rosman C, Strobbe L (2007) Pain after open preperitoneal repair versus Lichtenstein repair: a randomized trial. World J Surg 31:1751–1757
Amid PK (2004) Lichtenstein tension-free hernioplasty: its inception, evolution, and principles. Hernia 8:1–7
Kugel R (1999) Minimally invasive, nonlaparoscopic, preperitoneal and sutureless, inguinal herniorrhaphy. Am J Surg 178:298–302
Jerome A, Gross RT (1991) Pain disability index: construct and discriminant validity. Arch Phys Med Rehabil 72:920–922
Chibnall JT, Tait RC (1994) The pain disability index: factor structure and normative data. Arch Phys Med Rehabil 75:1082–1086
Merskey H, Bogduk N (1994) Classification of chronic pain: descriptions of chronic pain syndromes and definitions of pain terms. In: Merskey H, Bogduk N (eds) Task Force on Taxonomy of the IASP, 2nd edn. IASP, Seattle, pp 209–214
Kapural L, Hayek S, Malak O, Arrigain S, Maghail N (2006) Intradiscal thermal annuloplasty versus intradiscal radiofrequency ablation for the treatment of discogenic pain: a prospective matched control trial. Pain Med 6:425–431
Denison E, Asenlof P, Lindber P (2004) Self-efficacy, fear avoidance, and pain intensity as predictors of disability in subacute and chronic musculoskeletal pain patients in primary health care. Pain 111:245–252
Goldstein HS, Rabaza JR, Gonzalez AM, Verdeja JC (2003) Evaluation of pain and disability in plug repair with the aid of a personal digital assistant. Hernia 7:25–28
McCarthy M, Chang C (2005) Visual analog scales for assessing surgical pain. J Am Coll Surg 201:245–252
Kehlet H, Bay-Nielsen M, Kingsnorth A (2002) Chronic postherniorrhaphy pain: a call for uniform assessment. Hernia 6:178–181
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Staal, E., Nienhuijs, S.W., Keemers-Gels, M.E. et al. The impact of pain on daily activities following open mesh inguinal hernia repair. Hernia 12, 153–157 (2008). https://doi.org/10.1007/s10029-007-0297-1
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10029-007-0297-1