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Título

INGUINODYNIA AFTER INGUINAL HERNIOPLASTY: CLINICAL AND SURGICAL MANAGEMENT. LITERATURE REVIEW

Resumo

Introduction: Inguinodynia (chronic inguinal pain) is one of the most feared complications for surgeons after
inguinal hernia with prosthetic mesh placement. The biopsychosocial impact of this complication can lead to a
considerable decrease in patients' quality of life. Chronic inguinal pain can appear at varying periods after
surgery, for weeks to years after the surgical procedure. The pain is classified as neuropathic and nonneuropathic related to nerve injury and mesh, respectively. The diagnosis and clinical management of this
condition is a separate challenge for medical specialists in hernia surgery, requiring a thorough knowledge of
inguinal anatomy and advanced surgical knowledge, and literature references on the subject are still limited. In
this article we discuss the diagnostic and therapeutic tools as well as the surgical maneuvers for the
intervention of inguinodynia.
Methods: In this study, we conducted a literature review as a methodological strategy, searching for articles in
the Latin American and Caribbean Health Sciences (LILACS), Scientific Electronic Library Online (SciELO),
and National Library of Medicine (PubMed), in which descriptors were chosen and identified according to the
Medical Subject Headings (MeSH) and Health Sciences Descriptors (DeCS) lists of descriptors, as follows:
inguinal hernia; chronic pain; pain, postoperative Among the studies, articles published between 2012 and
2022 in English and Portuguese were eligible, not including book chapters and non-systematic reviews.
Results: Initially the articles were selected by title and abstract. The search found 132 articles, of which only 35
articles were included for this work. The flow chart presented shows the selection process, being conducted
according to the preferred information items for Systematic Reviews and Meta-Analyses Methodology
(PRISMA).
Conclusion: The presented review showed that there are still no well-established guidelines for the prevention
and management of inguinodynia, since its etiology may be multifactorial, requiring an individualized approach
for each case. Studies show that a good surgical technique can considerably decrease the risk of neurological
damage and chronic inguinal pain, but other patient-related factors may play an important role in its genesis.

Área

Cirurgia - Miscelânea