Peer-reviewed veterinary case report
How nerve handling affects pain one year after hernia surgery
By Westin L et al.·2026·Department of Trauma and Reparative Medicine·View original on Europe PMC →
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Original publication title: The impact of nerve management on the risk for persistent postoperative pain one year after open anterior mesh inguinal hernia repair.
Plain-English summary
This study looked at how managing certain nerves during inguinal hernia surgery might affect the chances of having ongoing pain a year later. Researchers analyzed data from a large group of adult patients who had this type of surgery between 2012 and 2017 and filled out a questionnaire about their pain a year afterward. They found that about 26% of patients experienced pain that was hard to ignore, and nearly 16% had pain that affected their daily activities. However, the way the nerves were handled during surgery didn't seem to make a difference in whether patients had persistent pain afterward. Overall, the study concluded that while careful handling of tissue is important, the specific management of these nerves did not lead to an increased risk of long-term pain after surgery.
Abstract
<h4>Purpose</h4>Persistent postoperative pain is a major challenge in inguinal hernia surgery. However, the impact of intraoperative nerve management on postoperative pain is poorly understood. The aim was to evaluate how management of the three inguinal nerves during anterior mesh repair of inguinal hernia affects the risk for persistent postoperative pain.<h4>Methods</h4>Cohort study based on data from the Swedish Hernia Register (SHR) concerning management of the three inguinal nerves. Adult patients with an open anterior mesh repair between 2012 and 2017 and who had responded to a patient-reported outcome measure (PROM) questionnaire one year after surgery were included in the study.<h4>Results</h4>Out of eligible patients, 34,115 (69%) responded to the PROM questionnaire. Of these, 25.9% reported pain that could not be ignored and 15.7% reported pain interfering with daily activities one year after surgery. Identifying and/or preserving any of the three groin nerves was not seen to have a significant impact on the risk for persistent groin pain in multivariable ordinal regression analysis adjusted for type of anaesthesia, gender, age and emergency surgery.<h4>Conclusion</h4>In a setting where the nerves are handled according to the surgeon's intraoperative judgement focusing on identifying and/or preserving the nerves, there was no association between intraoperative management of the three inguinal nerves and the risk for persistent postoperative pain one year after surgery. While careful tissue handling is crucial to the avoidance of postoperative pain, pragmatic nerve resection did not increase the risk for persistent pain one year after surgery.
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Search related cases →Original publication on Europe PMC: https://europepmc.org/article/MED/41557045