Chronic Postoperative Inguinal Pain after Inguinal Hernia Repair: Risk Factors and Surgical Technique Association

Background: Chronic postoperative inguinal pain (CPIP) has emerged as the most clinically significant complication following inguinal hernia repair, surpassing recurrence as the primary concern in modern hernia surgery. Despite advances in surgical techniques and prosthetic materials, CPIP continues to affect a substantial proportion of patients and remains incompletely understood in terms of its modifiable and non-modifiable risk determinants. Methods: This prospective cohort study enrolled 360 adult patients who underwent primary unilateral inguinal hernia repair at a tertiary surgical center. Patients were categorized by surgical technique: open Lichtenstein mesh repair (n = 186) and laparoscopic transabdominal preperitoneal (TAPP) repair (n = 174). Pain assessment was performed using the Visual Analogue Scale (VAS) and the Inguinal Pain Questionnaire (IPQ) preoperatively and at 1, 3, 6, and 12 months postoperatively. CPIP was defined as pain persisting beyond 3 months. Multivariate logistic regression identified independent risk factors. Results: CPIP at 6 months was present in 68 patients (18.9%). The incidence was significantly higher after open repair (23.1% vs. 14.4%; p = 0.034). Independent risk factors included younger age (