Chronic Pain and Sexual Dysfunction After Groin Hernia Repair in Adolescents: A Nationwide Survey.

Abstract

Objective: To assess the prevalence of chronic pain and sexual dysfunction after groin hernia repair in adolescents.

Summary background data: Adolescents present unique challenges in groin hernia management due to their evolving anatomy, yet data on patient-reported outcomes remain limited.

Methods: A nationwide survey was conducted in Denmark, linking patient-reported outcomes to the Danish National Patient Register and Civil Registration System. Patients who underwent primary unilateral groin hernia repair during adolescence (10-19 years) between 1992 and 2022 were identified. The primary outcome was chronic pain assessed with the short-form Inguinal Pain Questionnaire. Secondary outcomes included chronic pain assessed with the Activities Assessment Scale and sexual dysfunction assessed with the Sexual Inguinal Hernia Questionnaire.

Results: Among 2,486 participants (response rate: 60.8%) completing the survey (80% male; median age at repair 16 [IQR, 12-19] years), 7.3% (95% CI, 6.3-8.4) reported chronic pain across all follow-up periods. In participants with less than 15 years of follow-up, 9% to 15% reported chronic pain depending on age at the time of repair and repair method. Chronic pain during sexual activity was reported by 8.6% (95% CI, 7.5-10) of participants. No significant differences in chronic pain or sexual dysfunction were observed between repair methods. Femoral hernia repairs were rare.

Conclusions: Chronic pain and sexual dysfunction were common long-term complications of groin hernia repair in adolescents, regardless of repair methods. Optimizing outcomes could include a tailored, patient-centered approach by hernia experts, ensuring optimal care for this unique, young, low-volume population within hernia surgery.