Discussion
postoperative pain, hernia, pain, hernias, NRS
RECURRENCES, RECURRENCE, DIABETES MELLITUS, RECRUITMENT, SECONDARY, POST-OPERATIVE PROBLEMS, CHRONIC PAIN, DISEASES
A number of previous studies regarding postoperative pain after hernia surgery have focused on the impact of different meshes and fixation techniques on the acute and chronic pain. However, to our knowledge, this is the first study comparing the medium-term effect of self-gripping and self-adhesive mesh on the chronic pain after hernia surgery. Importantly, although short-term outcome [In general, patients have moderate pain due to inguinal hernia before surgery. This study present mean preoperative NRS scores between 4 and 5, equivalent to results in other trials [Further, we wanted to widen the perspective of postoperative pain to clinically important issues such as pain-related healthcare visits and category-based evaluation of pain recommended to be used by guidelines. The reality is, that even though mean pain scores in studies are low, a small number of patients suffer from considerable post-operative inguinal pain. The literature propose the use of pain scales such as numeric rating scale (NRS) or visual analogue scale (VAS) to assess pain intensity. Hjermstad et al. [Moreover, the advantage of self-adhesive mesh over self-gripping mesh, with respect to acute postoperative pain and faster recovery after surgery, which was detected in this trial [The indication for operative treatment of inguinal hernias is mainly pain or discomfort in the inguinal area [Except from pain-related issues, this study observed low recurrence rates; however, with an insufficient follow-up time, as only few recurrences are detected during the first year. Other research [This study has some limitations. First, reliable pain measurement is difficult. Many factors influence the sensation of pain. Therefore, we tried to present clinically relevant measurement which directly affect the patient or the health care system. Second, not all patients responded to the follow-up, nor where they routinely checked-up after surgery, although, as we have a national electronic health care database, considerable post-operative problems would have been detected during the reviewing of patients’ medical records at one year after surgery. Third, due to ethical reason, the recruitment of patients was terminated half-ways affecting the total number of recruited patients. The smaller sample size might have led to the lack of statistical differences between the groups. Also, the use of block randomization may cause imbalance in terms of secondary diseases such as diabetes mellitus. The strength of this study is the randomized clinical design and the comparable follow-up between the groups. This data provide knowledge on postoperative pain and its influence on actual daily life during the first year after surgery.