Effects of inguinal hernia repair on trunk muscle strength, quality of life, and neuropathic pain

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BACKGROUND: The Lichtenstein’s and Kugel’s procedures for inguinal hernia repair have been compared in terms of immediate complications, including hematoma, testicular pain and wound infection, and long-term outcomes such as chronic pain. OBJECTIVE: The aim of the present study was to compare trunk muscle strength, quality of life (QoL), and neuropathic pain (NP) components using a prospective controlled study following the above two procedures. METHODS: Sixty consecutive patients underwent elective inguinal hernia repair from 2013 until 2014. Thirty patients were operated using standard Lichtenstein, while 30 were treated with a Kugel patch. Six months after initial surgery, trunk muscle strength and patient QoL were evaluated. Additionally, 40 healthy volunteers, matched for age and sex, were recruited for comparison. Trunk muscle strength was measured isokinetically, whereas QoL and pain level were assessed using the Short Form 36 (SF-36) and the PainDETECT questionnaire (PD-Q), respectively. RESULTS: Mean peak moment of trunk flexion and trunk flexor-extensor (agonist/antagonist) ratio were significantly lower in patients than in controls, while no differences were observed between the two surgery groups. In addition, trunk extension strength was mearly identical in all there (2 experimental, 1 control) groups. Only two patients in the Lichtenstein group and one patient in the Kugel group showed a PD-Q score over 19 and NP component. There was no difference in the PD-Q scores and SF-36 domains between the different surgery groups. CONCLUSIONS: Based on the outcome parameters evaluated in this study, none of the two surgical interventions is superior to the other. Therefore, the particular choice of surgical procedure should rely on other factors.

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