Vinoth, D (2020) Prevalence of Inguinodynia in Patients Undergoing Hernioplasty in a Tertiary Care Hospital, Coimbatore: A Cross Sectional study. Masters thesis, PSG Institute of Medical Sciences and Research, Coimbatore.
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Abstract
INTRODUCTION: Repair of inguinal hernia, one of the most common surgical procedures performed, has over 20 million performed worldwide. Inguinodynia, which is a chronic pain following repair of inguinal hernia is significant, problem. It is under-reported. Randomized trials of laparoscopic vs open inguinal hernia repair have demonstrated similar recurrence rates with the use of mesh and have identified that chronic groin pain (>10%) surpasses recurrence (<2%) and is an important measure of success. Chronic groin pain is potentially disabling with neuralgia, paraesthesia, hypoesthesia, and hyperesthesia. Patients may be unable to work, have limited physical & social activities, sleep disturbances, and psychological distress. Chronic postoperative inguinal pain (postherniorrhaphy inguinodynia or CPIP) is defined by the International Association for the Study of Pain as "pain beyond three months after inguinal hernia surgery". Inguinodynia is generally classified as neuropathic pain and non-neuropathic which is an inflammatory or nociceptive pain. Neuropathic pain usually is a result of nerve entrapment either by the inserted mesh or direct damage to inguinal nerves during surgery, On the other hand, non-neuropathic chronic postherniorrhaphy pain may follow a mesh or suture induced inflammatory reaction of the inguinal region. Neuropathic inguinodynia ultimately can lead to a disabling disease. Recurrence is insufficient to make patients' lives miserable, with mesh repair reporting up to a 21% incidence of inguinodynia. This led to a proposal that mesh repairs be abandoned and the transversalis or Shouldice Hospital repair be adopted. Incidence in one study shows upto 62.9%. Reduction of inguinodynia thus is the clinical outcome that has the greatest impact on patient satisfaction, health care utilization, societal cost, and quality of life. AIMS AND OBJECTIVES: The aim of this study was to know the burden of inguinodynia in patients undergoing hernioplasty for inguinal hernias. 1. Primary objective: To estimate the 7prevalence of inguinodynia in patients undergoing hernioplasty in a tertiary health care centre in South India. 2. Secondary objective: To estimate the difference in prevalence of inguinodynia among open hernioplasty and laparoscopic hernioplasty (TEP and TAPP). METHODOLOGY: After obtaining institutional ethics committee approval, we have conducted a cross sectional study with 180 subjects recruited for the same. Calculating with a significance of p< 0.05%, we have calculated that the number of subjects in each arm was 49, 31, and 102 respectively. Analysis was done comparing the incidence of inguinodynia among the subjects. The prevalence was tabulated and analysed. Our secondary outcome was to determine the difference in prevalence among the various types of hernioplasties as differentiated in each group RESULTS: Data was compiled and analysed using Chi square test. It was noted that incidence of inguinodynia among the groups were 8.5, 12.9 and 9.8 % respectively. Overall, there was no statistically significant difference (p value 0.814, 0.821, 0.885) among the groups. CONCLUSION: As per this cross sectional study, the prevalence of inguinodynia is 10%. There is no statistically significant difference in the overall technique of hernioplasty employed.
| Item Type: | Thesis (Masters) |
|---|---|
| Additional Information: | 221711503 |
| Uncontrolled Keywords: | Prevalence, Inguinodynia, Undergoing Hernioplasty, Tertiary Care Hospital, Coimbatore, Cross Sectional study. |
| Subjects: | MEDICAL > General Surgery |
| Depositing User: | Subramani R |
| Date Deposited: | 12 Feb 2021 17:04 |
| Last Modified: | 12 Feb 2021 17:04 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/14069 |
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