Clinical and Socioeconomic Factors Related to Preoperative and Postoperative Groin Pain in Inguinal Hernia Repair.

BACKGROUND: Inguinal hernias are among the most prevalent surgical problems worldwide. Preoperative and postoperative groin pain has the potential to affect quality of life (QOL) significantly. The purpose of this study is to identify whether the pain experienced by patients may be predicted by a number of preoperative and postoperative clinical and socioeconomic factors.

METHODS: A retrospective review was conducted for all adult patients who underwent inguinal hernia repair with the study's senior author from January 1, 2016, to December 31, 2020. Data collected include medical history, groin pain ratings at preoperative and postoperative (2 wk) clinic visits, long-term pain, and quality of life (QOL) data >1 year after surgery. Median household income of the patient's residential zip code was used as a proxy for socioeconomic status (SES). Patient factors were evaluated for their correlation with pain ratings.

RESULTS: Three hundred eighty patients were included in this study. Patients with higher preoperative pain (rated 5-10 out of 10, vs . 0-4 out of 10) had higher postoperative pain on average (3.18 vs . 1.0, P <0.001). Nearly all patients with preoperative pain had partial or complete pain relief long-term. Obesity ( P <0.05) and smoking history ( P <0.05) were both associated with higher preoperative pain and greater pain reduction through surgery. Lower income ( P <0.05) and younger age ( P <0.05) were associated with higher preoperative and postoperative pain.

CONCLUSIONS: Obesity, smoking history, lower income, and younger age were all significantly associated with higher pain levels before surgery, with obesity and smoking also linked to greater pain reduction after surgery. These findings highlight potential disparities, but patients with severe preoperative pain and comorbid conditions can still benefit from pain relief through surgery.