Psychological disorders in patients with chronic postoperative inguinal pain

• Published in: Hernia : the journal of hernias and abdominal wall surgery 2023-02, Vol.27 (1), p.35-40
• Main Authors: Miller, B. T., Scheman, J., Petro, C. C., Beffa, L. R. A., Prabhu, A. S., Rosen, M. J., Krpata, D. M.
• Format: Article
• Language: English
• Subjects: Abdominal Surgery; Anxiety; Child; Children; Chronic Pain; Chronic Pain - epidemiology; Chronic Pain - etiology; Groin - surgery; Hernia; Hernia, Inguinal - complications; Herniorrhaphy - adverse effects; Humans; Medicine; Medicine & Public Health; Mental depression; Original Article; Pain; Pain, Postoperative - diagnosis; Pain, Postoperative - epidemiology; Pain, Postoperative - etiology; Post traumatic stress disorder; Psychological assessment; Retrospective Studies; Rumination
• ISSN: 1248-9204; 1265-4906; 1248-9204
• DOI: 10.1007/s10029-022-02662-2

Purpose Chronic postoperative inguinal pain (CPIP), a complication of inguinal hernia repair, may negatively affect mental health. The rates of psychological disorders in patients with CPIP are unknown. We aimed to describe the prevalence of psychological disorders coinciding with CPIP. Methods A retrospective chart review was performed of all patients seen at the Cleveland Clinic Center for Abdominal Core Health’s inter-disciplinary Chronic Groin Pain Clinic. This clinic is unique in that all patients are evaluated by a surgeon, a sonographer and radiologist, and a behavioral medicine psychologist. Patient psychological history and treatment, Depression Anxiety and Stress Scale (DASS) scores, pain catastrophizing, and trauma or abuse history were captured. Results From January 2018 to January 2022, 61 patients were evaluated and included in the study. Psychological treatment had been provided to 37 (61%) patients (present: 16 (27%), past: 21 (35%)). The most common psychological disorders represented were depression ( N  = 13, 22%), anxiety ( N  = 10, 17%), and post-traumatic stress disorder ( N  = 5, 8%). DASS scores indicated that 20 (33%) patients were reporting symptoms of depression and 16 (27%) patients were reporting symptoms of anxiety. Of the 40 patients assessed for pain catastrophizing, 28 (70%) reported rumination, 9 (23%) reported magnification, and 23 (58%) reported feelings of helplessness. A childhood history of emotional or physical abuse was reported by 11 (18%) patients. Conclusion An inter-disciplinary groin pain clinic has revealed that patients with CPIP frequently have pre-existing complex psychosocial issues. A multi-specialty approach to CPIP may improve preoperative assessments and identify patients who may benefit from further psychological evaluation and treatment.