PREVALENCE AND DETERMINANTS OF INGUINODYNIA FOLLOWING INGUINAL HERNIOPLASTY: A PROSPECTIVE STUDY IN A TERTIARY CARE SETTING

Abstract

Background: Inguinodynia  chronic groin pain persisting beyond three months following inguinal hernia repair — has emerged as a critical measure of surgical success, frequently outweighing recurrence as the leading postoperative concern(1,2). This study determined the prevalence, severity, and associated risk factors of inguinodynia in a tertiary-care population in Vadodara, Gujarat. Methods: A prospective observational study was conducted on 200 patients undergoing inguinal hernioplasty (open Lichtenstein, laparoscopic TEP, or laparoscopic TAPP) between January 2024 and December 2025 at Smt. B.K. Shah Medical Institute and Research Centre, Vadodara. Pain intensity was quantified using the 10-cm Visual Analogue Scale at four time points: immediate postoperative, postoperative day 2, postoperative day 14, and 3 months. Inguinodynia was analyzed against variables including surgical technique, mesh type, nerve handling, and comorbidities using chi-square tests and repeated-measures ANOVA. Results: The overall prevalence of inguinodynia at 3 months was 18.0% (36 of 200 patients). Bilateral inguinal hernia (37.5%) and open hernioplasty (37.5%) were the most common presentations. Among affected participants, 36.5% reported severe pain and 35.0% moderate pain. Stabbing pain was the most frequent character (32.0%), suggesting a neuropathic phenotype(2). Mesh type was the only variable significantly associated with chronic pain (), with lightweight mesh used in 50% of inguinodynia cases. Conclusion: Inguinodynia affects approximately 18% of patients following hernioplasty, with pain intensity typically severe and character predominantly neuropathic. Mesh selection appears to be a major determinant of chronic pain development, whereas surgical technique, nerve handling, and analgesia protocol showed less impact in this cohort.