Methods

The term ‘chronic post-herniorrhaphy pain’has a wide variety of interpretations in the literature. The International Association for the Study of Pain has defined chronic pain as pain lasting more than 3 months. 20 However, with the modern use of synthetic mesh for hernia repair, an inflammatory response may last a couple of months as a result of a reaction against the foreign material. The criteria for inclusion in this review were therefore: studies of pain more than/equal to 6 months after hernia surgery and including more than/equal to 100 patients. A search was made using the PUBMED search engine (National Centre for Biotechnology Information, US National Library of Medicine, USA), and the Ovid search engine (Ovid Technologies, Wolters Kluwer, Amsterdam, The Netherlands). We searched both databases in May 2004 and covered the period January 2000 through to April 2004. The term ‘pain’was combined with the term ‘hernia, inguinal’. Other words associated with pain were explored, such as ‘neuropathy’,‘discomfort’,‘complications’,‘consequences’, and ‘results’. The search was restricted to ‘adult 19+’and ‘English language’. In addition, some articles published during the review process after April 2004 were included, as were articles known by the authors, but not found in the databases. References were crosschecked for literature not found in the database search. Reviews were checked for additional studies. Letters to the editor and abstracts were not included.