8/23/2019 Chronic Groin Pain after Inguinal Hernia Repair | Cleveland Clinic

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Chronic Groin Pain after Inguinal Hernia Repair

Chronic groin pain is de ned as pain that is present for more than 3 months after
inguinal hernia surgery. Symptoms include pain and a burning sensation in the area
of the surgery. Treatments include pain medications and nerve blocks.

What is chronic groin pain after inguinal hernia repair?

Chronic groin pain is de ned as pain that is present for more than 3 months after the inguinal
hernia surgery. Chronic groin pain can occur in more than 15% of patients who have this
surgery.

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What is an inguinal hernia?

A hernia is a condition in which part of an internal organ or tissue bulges through a muscle. In an
inguinal hernia, the intestines or fat from the abdomen push through the lower abdominal wall
into the inguinal, or groin, area.

An inguinal hernia is usually not dangerous. However, it can be painful, especially when lifting,
bending, straining with a bowel movement, or coughing. If a hernia bulges out and cannot be
pushed back, or reduced, this is an emergency and you should seek immediate medical
attention.

Inguinal hernias include the following:

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Indirect inguinal hernias: This is caused by a birth defect in the abdominal wall.
Direct inguinal hernias: These are most often caused by a weakness in the muscles of the
abdominal wall that develops over time, or by straining or heavy lifting.
Incarcerated hernia: Incarceration occurs when part of the fat or intestine from inside the
abdomen gets stuck in the groin or scrotum and cannot go back into the abdomen.
Strangulated hernia: A strangulated hernia is an incarcerated hernia that has not been
treated. The blood supply to the intestine can be cut off, causing “strangulation” of the
intestine. This is a very serious condition that must be treated immediately.

What are the symptoms of an inguinal hernia?

Symptoms of an inguinal hernia can include:

A bulge on one or both sides of the groin that disappears when lying down
Pain in the groin, especially when lifting, coughing or exercising
A feeling of weakness, heaviness or burning in the groin
A swollen scrotum

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How is an inguinal hernia treated?

An inguinal hernia is usually treated with surgery. There are two main types of inguinal hernia
surgery:

Open hernia repair: An incision, or cut, is made in the groin. The surgeon then pushes the
hernia back into the abdomen and strengthens the abdominal wall with mesh and stitches.
Laparoscopic (minimally invasive) hernia repair: The surgeon makes small cuts in the lower
abdomen and inserts a laparoscope (a thin tube with a tiny video camera attached). The
laparoscope sends images to a video monitor, allowing the surgeon to repair the hernia.

What happens after inguinal hernia repair surgery?

Patients who have surgery usually need medication for several weeks to treat pain. Patients are
also advised to not lift anything heavy or engage in vigorous activity.

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Minimally invasive hernia surgery usually has a shorter recovery time. However, it may not be
an option for patients with large hernias or for those who have had previous abdominal surgery.

What are the risks of inguinal hernia repair surgery?

Inguinal hernia repair is a very common surgery. However, like all surgeries, it has some risks,
including infection, bleeding, and pain that is not relieved by medication. Long-term
complications are rare, but can include nerve damage. In addition, the hernia can recur (come
back), which would require a second surgery.

What are the symptoms of chronic groin pain after surgery?

The symptoms of chronic groin pain after surgery include:

Ad
Sharp or radiating (spreading) pain;
A burning sensation in the area of the surgery;
Foreign body sensation (feeling like there is something strange in the body);
Pain in the testicles;
Pain when walking;
Pain with sexual intercourse.

How is chronic groin pain after inguinal hernia repair treated?

Management of chronic groin pain can be challenging and requires a team of health care
professionals working together.

There are several treatment options for chronic groin pain after inguinal hernia repair,
including:

Pain medications
Nerve block (injection of a local anesthetic)
Nerve ablation (an electric current heats up a small area of nerve tissue to stop it from
sending pain signals)
Peripheral nerve eld stimulation (electrodes are placed on the nerves to stop the pain)

Surgery is an option for patients who have had a thorough consultation and examination by a
surgeon. Surgery can be performed through an open incision (over the previous surgery) or

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laparoscopically. During the surgery, the surgeon may partially or completely remove the hernia
mesh that was placed in the earlier surgery.

Depending on the nature of the groin pain, some patients will bene t from a neurectomy. This is
a procedure in which one or more of the peripheral nerves around the previous surgery are cut.

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References:

American College of Surgeons. Groin Hernia Repair. Accessed 6/15/2018.

Society of American Gastrointestinal and Endoscopic Surgeons. Laparoscopic Inguinal
Hernia Repair Surgery--Patient Information from SAGES. Accessed 6/15/2018.

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Nienhuijsa SW, Rosmanb C, Strobbe LJA. et al. An overview of the features in uencing pain
after inguinal hernia repair. International Journal of Surgery Volume 6, Issue 4, August
2008, Pages 351-356. https://doi.org/10.1016/j.ijsu.2008.02.005

This information is provided by the Cleveland Clinic and is not intended to replace the medical advice
of your doctor or healthcare provider. Please consult your healthcare provider for advice about a
speci c medical condition. This document was last reviewed on: 06/15/2018

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