Ultrasonography in diagnosis and analysis of chronic pain following anterior open inguinal herniorrhaphy

Objective Chronic pain as a complication following inguinal herniorrhaphy has attracted increasing attention in recent years. There is evidence that chronic pain seriously affects patients' quality of life. However, there are few studies and data regarding imaging-based diagnosis of the etiology of chronic pain. Objective To explore the etiology as well as to analysis ultrasonographic imaging description of chronic pain following anterior open inguinal herniorrhaphy. Methods Ultrasonography was performed on 164 sites at which chronic pain was felt following anterior open inguinal herniorrhaphy to identify the main causes of the chronic postoperative pain. Positive ultrasound findings which appeared at the same time were grouped for comparisons. Results There are positive ultrasound diagnoses of chronic postoperative pain: encapsulated effusion, edema of the scrotal wall, testitis, hydrocele testis, limited motion of the spermatic cord at the reconstructed deep inguinal ring, varicocele, scar hyperplasia at pubic sutures, mesh shrinkage, patch or mesh plug accumulation, recurrent hernia, spermatic cord cyst as well as cyst of the caput epididymis. In terms of the pairwise merge of positive ultrasound diagnoses, there were significant differences between the respective groups in encapsulated effusion with scrotal wall edema, varicocele with limited motion of the spermatic cord at the reconstructed deep inguinal ring, and mesh shrinkage with recurrent hernia (χ2=41.37、20.07、13.19、7.36, P<0.05). Conclusion Ultrasonography offer important benefits in the diagnosis of chronic pain following anterior open inguinal herniorrhaphy. Some positive findings cause chronic pain at the same time, which is necessary for doctors to consider comprehensively while making a diagnosis. Key words: Hernia, inguinal; Herniorrhaphy; Ultrasonography; Chronic pain