Table 1.

Risk factors for chronic postherniorrhaphy inguinal pain

Preoperative factors

Young age3,9,24,35,36,43

Female sex3,9,24,35,36,43

High pain intensity level (inguinal/elsewhere)3,9,24,35,36,45

Lower preoperative optimism49

Impairment of everyday activities42

Operation for a recurrent hernia2,9

Genetic predisposition (DQB1*03:02 HLA haplotype)59

Experimentally induced pain

High pain intensity to tonic heat stimulation42

Perioperative factors

Less experienced surgeon/not dedicated hernia center9

Open repair technique9,11,35,36,42,50

Mesh type: heavyweight (open,37 laparoscopic38)

Mesh fixation: suture (open40,41), staple (laparoscopic39)?

IIN neurolysis in Lichtenstein repair45

Postoperative factors

Postoperative complications (hematoma, infection)35,36

High early postoperative pain intensity9,42

Lower perceived control over pain49

Sensory dysfunction in the groin24,42,45

Note: ? = conflicting opinions/mixed evidence.

Abbreviations: IIN, ilioinguinal nerve; HLA, human leukocyte antigen.