You may have been slightly concerned if you noticed an abnormal bulge on one side of your pubic bone, but you probably began to worry when that bulge grew larger or started feeling achy, tender, heavy, or weak.

Even if you never experienced major discomfort in your groin, or a sharp or shooting pain every time you coughed, bent over, or lifted something heavy, chances are your doctor was able to diagnose your inguinal hernia pretty quickly.

A hernia occurs when some type of tissue protrudes through a hole or weak spot in the overlying muscle or connective tissue. Although they can develop anywhere along your abdominal wall, hernias often emerge in lowest part of the abdomen, or groin.

Because a hernia can’t heal on its own — and because it can lead to dangerous and even life-threatening complications — it’s usually repaired surgically. Although inguinal hernia repair has a high success rate, up to 16% of patients continue to experience chronic groin pain after surgery.

If you’re experiencing persistent groin pain following inguinal hernia repair surgery, here’s what you should know about its possible causes, and how you may be able to find relief.

Inguinal hernia repair 101

Hernia repair is among the most common surgeries in the United States, accounting for more than a million procedures each year. A full 80% of those procedures — or four in five hernia repair operations — are done to correct an inguinal hernia.

Although inguinal hernias are sometimes repaired via conventional surgery, they’re usually repaired laparoscopically, using small incisions, specialized instruments, and a high-definition camera to get the job done without causing unnecessary trauma to surrounding tissues.

In over 90% of inguinal hernia surgeries, the repair itself is made using surgical mesh, a biocompatible implant that helps strengthen the abdominal wall and reduce the risk of recurrence. Using surgical mesh to repair a hernia is also associated with decreased operative time, minimized recovery time, and improved patient outcomes.

Hernia repair surgery complications

After a hernia repair procedure, most patients experience some degree of groin pain or discomfort as their incision heals and their body adjusts to the surgical mesh. Post-operative pain, a type of lingering pain that can last up to three months following surgery, usually improves as mesh-related inflammation subsides.

Chronic postoperative groin pain that persists for six months or longer is less common. When it does occur, it may be the result of any number of complications. Most often, long-term postoperative groin pain is caused by one of the following:

Mesh-related problems

The mesh used in inguinal hernia repair can lead to chronic pain if it affects the surrounding tissues in an abnormal way. This can happen when your body recognizes the material as a foreign object, causing the kind of inflammatory response that gives rise to chronic pain; it can also occur when the mesh inadvertently rubs or otherwise irritates nearby muscles or nerves.

Less commonly, chronic pain following an inguinal hernia repair is a result of mesh migration or mesh contraction (shrinkage).

Unintentional nerve disturbance

Although surgeons take the utmost care to handle tissues gently and steer clear of nearby nerves when performing inguinal hernia repair, it’s not always possible to avoid unintentional nerve disturbance.

Although most nerve injuries will heal over time, you may experience chronic groin pain if any one of the three major nerves that run through your abdomen are caught in, impinged on, or otherwise irritated by the mesh itself.

Postoperative groin pain solutions

If your groin pain isn’t disruptive and hasn’t lasted longer than a couple of months, a period of “watchful waiting” is often recommended. Most cases of postoperative groin pain diminish on their own.

If your pain doesn’t improve or gets worse, you may benefit from anti-inflammatory pain medications, nerve blocks, or nerve ablation, a minimally invasive procedure that uses electrical currents to decrease nerve pain.

If a comprehensive investigation reveals that nerve damage is the main cause of your pain problem, you may be a good candidate for a neurectomy, or a type of surgery designed to provide long-term pain relief by removing all or part of a damaged nerve.

When surgical mesh is either the main cause or a contributing cause of chronic postoperative groin pain, having a follow-up surgery to remove the mesh is often the best solution.

Here at South Shore Surgical, we take chronic postoperative groin pain seriously — besides finding ways to help you manage your pain in the short-term, we’ll look for the underlying cause of your problem so we can offer an effective, long-term solution.

To learn more, call our Valley Stream, New York, office today, or use the easy online tool to schedule a visit with hernia repair expert Dr. Klonsky anytime.

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