The Experts below are selected from a list of 2175 Experts worldwide ranked by ideXlab platform
Henrik Kehlet - One of the best experts on this subject based on the ideXlab platform.
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Dysejaculation after laparoscopic inguinal Herniorrhaphy: a nationwide questionnaire study
Surgical endoscopy, 2011Co-Authors: Joakim M. Bischoff, Gitte Linderoth, Eske Kvanner Aasvang, Mads U. Werner, Henrik KehletAbstract:Background Dysejaculation and pain from the groin and genitals during sexual activity represent a clinically significant problem in up to 4% of younger males after open inguinal Herniorrhaphy. The aim of this questionnaire study is to assess the prevalence of dysejaculation and pain during sexual activity after laparoscopic inguinal Herniorrhaphy on a nationwide basis.
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international guidelines for prevention and management of post operative chronic pain following inguinal hernia surgery
Hernia, 2011Co-Authors: Sergio Alfieri, Henrik Kehlet, Parviz K Amid, G Campanelli, G Izard, A R Wijsmuller, Davio Di Miceli, Giovanni Battista DogliettoAbstract:Purpose To provide uniform terminology and definition of post-Herniorrhaphy groin chronic pain. To give guidelines to the scientific community concerning the prevention and the treatment of chronic groin and testicular pain.
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pain related sexual dysfunction after inguinal Herniorrhaphy
Pain, 2006Co-Authors: Eske Kvanner Aasvang, Morten Baynielsen, Bo Mohl, Henrik KehletAbstract:Abstract To determine the incidence of pain related sexual dysfunction 1 year after inguinal Herniorrhaphy and to assess the impact pain has on sexual function. In contrast to the well-described about 10% risk of chronic wound related pain after inguinal Herniorrhaphy, chronic genital pain, dysejaculation, and sexual dysfunction have only been described sporadically. The aim was therefore to describe these symptoms in a questionnaire study. A nationwide detailed questionnaire study in September 2004 of pain related sexual dysfunction in all men aged 18–40 years undergoing inguinal Herniorrhaphy between October 2002 and June 2003 (n = 1015) based upon the nationwide Danish Hernia Database collaboration. The response rate was 68.4%. Combined frequent and moderate or severe pain from the previous hernia site during activity was reported by 187 patients (18.4%). Pain during sexual activity was reported by 224 patients (22.1%), of which 68 (6.7%) had moderate or severe pain occurring every third time or more. Genital or ejaculatory pain was found in 125 patients (12.3%), and 28 (2.8%) patients reported that the pain impaired their sexual activity to a moderate or severe degree. Pain during sexual activity and subsequent sexual dysfunction represent a clinically significant problem in about 3% of younger male patients with a previous inguinal Herniorrhaphy. Intraoperative nerve damage and disposition to other chronic pain conditions are among the most likely pathogenic factors.
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pain and functional impairment 6 years after inguinal Herniorrhaphy
Hernia, 2006Co-Authors: Eske Kvanner Aasvang, Morten Baynielsen, Henrik KehletAbstract:Pain impairing daily activities following inguinal Herniorrhaphy is reported by about 10% of patients, when asked 1-2 years postoperatively. However, the time course and consequences of postHerniorrhaphy pain is not known in detail. A nationwide follow-up questionnaire study was undertaken 6.5 years postoperatively in 335 well-described patients reporting pain 1 year after inguinal Herniorrhaphy in a previous questionnaire study. Three hundred and three patients, who were alive and could be contacted, received a questionnaire 6.5 years after the Herniorrhaphy. Response rate was 88%. Of 267 patients responding, 57 were analyzed separately due to subsequent inguinal Herniorrhaphy or other major surgery in the observation period, leaving 210 patients (69.3%) for primary analysis. Pain from the previous hernia site was reported by 72 patients (34.3%), and 52 patients (24.8%) reported that pain affected daily activities. Less pain, compared to the 1-year follow-up, was reported by 75.8%, while 16.7% had the same intensity level and 7.5% reported increased pain severity. In the subgroup of patients operated for a recurrence during the observation period and not included in primary analysis, 22 of 44 (50%) still experienced pain at 6.5 years, and 17 (38.6%) reported that pain affected daily activities (mean observation period 4.5 years). Pain after inguinal Herniorrhaphy decreased from about 11% 1 year after surgery, but still affects daily activities in about 6% after 6.5 years. Patients operated for a recurrence are at higher risk for persistent pain.
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inguinal Herniorrhaphy in women
Hernia, 2006Co-Authors: Morten Baynielsen, Henrik KehletAbstract:Inguinal hernias in women are relatively rare, and an outcome in this specific subgroup of hernias has not been documented in the literature. An analysis was performed using data from the prospective recording of 3,696 female inguinal hernia repairs in the national Danish hernia database, in the 5.5 year period from January 1, 1998 to June 30, 2003, where observation time specific reoperation rates were used as a proxy for recurrence. In the 3,696 female inguinal herniorrhaphies recorded, the overall reoperation rate was 4.3%, which is slightly higher compared to male inguinal herniorrhaphies (3.1%) (P=0.001). The reoperation rate was independent of the type of surgical repair. In 41.5% of the reoperations a femoral hernia was found, compared to 5.4% in males. Female inguinal Herniorrhaphy is followed by a higher reoperation rate than in males, and is unrelated to the type of repair. The frequent finding of a femoral hernia at reoperation suggests the need for the exploration of the femoral canal at the primary operation.
Morten Baynielsen - One of the best experts on this subject based on the ideXlab platform.
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pain related sexual dysfunction after inguinal Herniorrhaphy
Pain, 2006Co-Authors: Eske Kvanner Aasvang, Morten Baynielsen, Bo Mohl, Henrik KehletAbstract:Abstract To determine the incidence of pain related sexual dysfunction 1 year after inguinal Herniorrhaphy and to assess the impact pain has on sexual function. In contrast to the well-described about 10% risk of chronic wound related pain after inguinal Herniorrhaphy, chronic genital pain, dysejaculation, and sexual dysfunction have only been described sporadically. The aim was therefore to describe these symptoms in a questionnaire study. A nationwide detailed questionnaire study in September 2004 of pain related sexual dysfunction in all men aged 18–40 years undergoing inguinal Herniorrhaphy between October 2002 and June 2003 (n = 1015) based upon the nationwide Danish Hernia Database collaboration. The response rate was 68.4%. Combined frequent and moderate or severe pain from the previous hernia site during activity was reported by 187 patients (18.4%). Pain during sexual activity was reported by 224 patients (22.1%), of which 68 (6.7%) had moderate or severe pain occurring every third time or more. Genital or ejaculatory pain was found in 125 patients (12.3%), and 28 (2.8%) patients reported that the pain impaired their sexual activity to a moderate or severe degree. Pain during sexual activity and subsequent sexual dysfunction represent a clinically significant problem in about 3% of younger male patients with a previous inguinal Herniorrhaphy. Intraoperative nerve damage and disposition to other chronic pain conditions are among the most likely pathogenic factors.
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pain and functional impairment 6 years after inguinal Herniorrhaphy
Hernia, 2006Co-Authors: Eske Kvanner Aasvang, Morten Baynielsen, Henrik KehletAbstract:Pain impairing daily activities following inguinal Herniorrhaphy is reported by about 10% of patients, when asked 1-2 years postoperatively. However, the time course and consequences of postHerniorrhaphy pain is not known in detail. A nationwide follow-up questionnaire study was undertaken 6.5 years postoperatively in 335 well-described patients reporting pain 1 year after inguinal Herniorrhaphy in a previous questionnaire study. Three hundred and three patients, who were alive and could be contacted, received a questionnaire 6.5 years after the Herniorrhaphy. Response rate was 88%. Of 267 patients responding, 57 were analyzed separately due to subsequent inguinal Herniorrhaphy or other major surgery in the observation period, leaving 210 patients (69.3%) for primary analysis. Pain from the previous hernia site was reported by 72 patients (34.3%), and 52 patients (24.8%) reported that pain affected daily activities. Less pain, compared to the 1-year follow-up, was reported by 75.8%, while 16.7% had the same intensity level and 7.5% reported increased pain severity. In the subgroup of patients operated for a recurrence during the observation period and not included in primary analysis, 22 of 44 (50%) still experienced pain at 6.5 years, and 17 (38.6%) reported that pain affected daily activities (mean observation period 4.5 years). Pain after inguinal Herniorrhaphy decreased from about 11% 1 year after surgery, but still affects daily activities in about 6% after 6.5 years. Patients operated for a recurrence are at higher risk for persistent pain.
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inguinal Herniorrhaphy in women
Hernia, 2006Co-Authors: Morten Baynielsen, Henrik KehletAbstract:Inguinal hernias in women are relatively rare, and an outcome in this specific subgroup of hernias has not been documented in the literature. An analysis was performed using data from the prospective recording of 3,696 female inguinal hernia repairs in the national Danish hernia database, in the 5.5 year period from January 1, 1998 to June 30, 2003, where observation time specific reoperation rates were used as a proxy for recurrence. In the 3,696 female inguinal herniorrhaphies recorded, the overall reoperation rate was 4.3%, which is slightly higher compared to male inguinal herniorrhaphies (3.1%) (P=0.001). The reoperation rate was independent of the type of surgical repair. In 41.5% of the reoperations a femoral hernia was found, compared to 5.4% in males. Female inguinal Herniorrhaphy is followed by a higher reoperation rate than in males, and is unrelated to the type of repair. The frequent finding of a femoral hernia at reoperation suggests the need for the exploration of the femoral canal at the primary operation.
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pain and functional impairment 1 year after inguinal Herniorrhaphy a nationwide questionnaire study
Annals of Surgery, 2001Co-Authors: Morten Baynielsen, Frederick M Perkins, Henrik KehletAbstract:Chronic pain after inguinal Herniorrhaphy is not rare, but the reported frequency of pain varies from 0% to 37%. 1–7 However, the extent to which chronic pain impairs function has not been well described. The development of chronic pain after inguinal Herniorrhaphy has been attributed to several mechanisms, including damage to well-defined sensory nerves (ilioinguinal, iliohypogastric, and genitofemoral) 8 and “mesh inguinodynia.”9 Several factors have been proposed as predictors of chronic pain, including surgery for a recurrent hernia, 10 intensity of early postoperative pain, 3,10 insurance status of the patient, 11 degree of specialization and experience of the surgeon, 12 and the type of surgical procedure used. Liem et al 2 found a lower incidence of pain after a laparoscopic hernia repair (2%) than an open nonmesh repair (14%). Dirksen et al 4 found no difference in the development of chronic pain after a Bassini repair (12%) versus a laparoscopic repair (15%). Hay et al, 6 in a large multicenter trial including 1,578 patients, found an overall pain incidence of 7%, with no significant differences among the different types of nonmesh, open hernia repairs. Rutkow and Robbins, 13 in contrast, found a chronic pain incidence of 0% in their case series of recurrent hernias, using a tension-free mesh repair. None of these studies of surgical technique had chronic pain as a primary outcome parameter, and the definitions of chronic pain were inconsistent. A large-scale multicenter study addressing postHerniorrhaphy pain found moderate to severe pain in 12% of patients. 3 However, this study is difficult to interpret because approximately 62% of the participating patients were excluded or lost to follow-up. Because patient selection and participation in clinical trials may influence the long-term outcome, the frequency of chronic pain after inguinal Herniorrhaphy in the general population is unknown. The low recurrence rates associated with the use of mesh repair may shift focus from recurrence to other outcome parameters. Further, all frequent and negative consequences of surgery should be considered when discussing the indication for surgery with the patient. We have therefore attempted to establish the frequency and significance of pain after inguinal Herniorrhaphy in a nationwide population.
Simon W Nienhuijs - One of the best experts on this subject based on the ideXlab platform.
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ultrasound guided ilioinguinal iliohypogastric nerve blocks for chronic pain after inguinal hernia repair
Hernia, 2013Co-Authors: Irene Thomassen, J A Van Suijlekom, A Van De Gaag, J E H Ponten, Simon W NienhuijsAbstract:Purpose The aim of this study was to evaluate the outcome of ilioinguinal and iliohypogastric nerve blocks in patients with chronic pain after Herniorrhaphy, by comparing nerve stimulator and ultrasound guidance to administer the block.
M. A. Memon - One of the best experts on this subject based on the ideXlab platform.
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Causes of recurrences after open inguinal Herniorrhaphy
Hernia, 2019Co-Authors: D. Ashrafi, M. Siddaiah-subramanya, B. Memon, M. A. MemonAbstract:Purpose One of the most important measures of success of open inguinal Herniorrhaphy is the incidence of recurrence. Reports suggest that up to 13% of all inguinal hernia repairs worldwide, irrespective of the approach, are repaired for recurrence. The reason as to why inguinal hernias recur is most likely multifactorial. The aim of this review is to evaluate the risk factors responsible for these recurrences in open suture and mesh techniques. Methods A search of the Medline, Embase, Science Citation Index, Current Contents and PubMed databases identified English language, peer-reviewed articles on the causes of recurrence following open inguinal Herniorrhaphy published between 1990 and 2018. The search terms included ‘Inguinal hernia’; ‘Open methods’; ‘Suture repair’; ‘Mesh repair’, ‘Recurrence’, ‘Causes’, ‘Humans’. Results The literature revealed several contributing modifiable and non-modifiable risk factors that were responsible for recurrence following open suture and mesh inguinal Herniorrhaphy. These included perioperative, patient and hernia factors. Conclusions Despite the advent of laparoscopic techniques, open inguinal Herniorrhaphy remains one of the most common surgical operations. With open inguinal hernia repairs, risk factors for recurrence can be broadly classified into perioperative, patient and hernia factors. Certain patient and technical risk factors are modifiable and could reduce the recurrence rate. However, many others factors are non-modifiable. It is therefore imperative that the outcome of open inguinal Herniorrhaphy must be optimised by careful planning and education for both surgeons and patients to achieve the lowest possible risk of subsequent surgery for recurrence.
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causes of recurrences after open inguinal Herniorrhaphy
Hernia, 2019Co-Authors: D. Ashrafi, B. Memon, Manjunath Siddaiahsubramanya, M. A. MemonAbstract:One of the most important measures of success of open inguinal Herniorrhaphy is the incidence of recurrence. Reports suggest that up to 13% of all inguinal hernia repairs worldwide, irrespective of the approach, are repaired for recurrence. The reason as to why inguinal hernias recur is most likely multifactorial. The aim of this review is to evaluate the risk factors responsible for these recurrences in open suture and mesh techniques. A search of the Medline, Embase, Science Citation Index, Current Contents and PubMed databases identified English language, peer-reviewed articles on the causes of recurrence following open inguinal Herniorrhaphy published between 1990 and 2018. The search terms included ‘Inguinal hernia’; ‘Open methods’; ‘Suture repair’; ‘Mesh repair’, ‘Recurrence’, ‘Causes’, ‘Humans’. The literature revealed several contributing modifiable and non-modifiable risk factors that were responsible for recurrence following open suture and mesh inguinal Herniorrhaphy. These included perioperative, patient and hernia factors. Despite the advent of laparoscopic techniques, open inguinal Herniorrhaphy remains one of the most common surgical operations. With open inguinal hernia repairs, risk factors for recurrence can be broadly classified into perioperative, patient and hernia factors. Certain patient and technical risk factors are modifiable and could reduce the recurrence rate. However, many others factors are non-modifiable. It is therefore imperative that the outcome of open inguinal Herniorrhaphy must be optimised by careful planning and education for both surgeons and patients to achieve the lowest possible risk of subsequent surgery for recurrence.
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suture cruroplasty versus prosthetic hiatal Herniorrhaphy for large hiatal hernia a meta analysis and systematic review of randomized controlled trials
Annals of Surgery, 2016Co-Authors: M. A. Memon, Breda Memon, Rossita M Yunus, Shahjahan KhanAbstract:OBJECTIVE: The aim was to conduct a meta-analysis of randomized controlled trials (RCTs) comparing 2 methods of hiatal closure for large hiatal hernia and to evaluate their strengths and flaws. METHODS: Prospective RCTs comparing suture cruroplasty versus prosthetic hiatal Herniorrhaphy for large hiatal hernia were selected by searching PubMed, Medline, Embase, Science Citation Index, Current Contents, and the Cochrane Central Register of Controlled Trials published between January 1991 and October 2014. The outcome variables analyzed included operating time, complications, recurrence of hiatal hernia or wrap migration, and reoperation. These outcomes were unanimously decided to be important because they influence the practical approach toward patient management. Random effects model was used to calculate the effect size of both dichotomous and continuous data. Heterogeneity among the outcome variables of these trials was determined by the Cochran's Q statistic and I index. The meta-analysis was prepared in accordance with Preferred Reporting of Systematic Reviews and Meta-Analyses guidelines. RESULTS: Four RCTs were analyzed totaling 406 patients (Suture = 186, Prosthesis = 220). For only 1 of the 4 outcomes, ie, reoperation rate (OR 3.73, 95% CI 1.18, 11.82, P = 0.03), the pooled effect size favored prosthetic hiatal Herniorrhaphy over suture cruroplasty. For other outcomes, comparable effect sizes were noted for both groups which included recurrence of hiatal hernia or wrap migration (OR 2.01, 95% CI 0.92, 4.39, P = 0.07), operating time (SMD -0.46, 95% CI -1.16, -0.24, P = 0.19) and complication rates (OR 1.06, 95% CI 0.45, 2.50, P = 0.90). CONCLUSIONS: On the basis of our meta-analysis and its limitations, we believe that the prosthetic hiatal Herniorrhaphy and suture cruroplasty produces comparable results for repair of large hiatal hernias. In the future, a number of issues need to be addressed to determine the clinical outcomes, safety, and effectiveness of these 2 methods for elective surgical treatment of large hiatal hernias. Presently, the use of prosthetic hiatal Herniorrhaphy for large hiatal hernia cannot be endorsed routinely and the decision for the placement of mesh needs to be individualized based on the operative findings and the surgeon's recommendation.
Eske Kvanner Aasvang - One of the best experts on this subject based on the ideXlab platform.
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Dysejaculation after laparoscopic inguinal Herniorrhaphy: a nationwide questionnaire study
Surgical endoscopy, 2011Co-Authors: Joakim M. Bischoff, Gitte Linderoth, Eske Kvanner Aasvang, Mads U. Werner, Henrik KehletAbstract:Background Dysejaculation and pain from the groin and genitals during sexual activity represent a clinically significant problem in up to 4% of younger males after open inguinal Herniorrhaphy. The aim of this questionnaire study is to assess the prevalence of dysejaculation and pain during sexual activity after laparoscopic inguinal Herniorrhaphy on a nationwide basis.
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pain related sexual dysfunction after inguinal Herniorrhaphy
Pain, 2006Co-Authors: Eske Kvanner Aasvang, Morten Baynielsen, Bo Mohl, Henrik KehletAbstract:Abstract To determine the incidence of pain related sexual dysfunction 1 year after inguinal Herniorrhaphy and to assess the impact pain has on sexual function. In contrast to the well-described about 10% risk of chronic wound related pain after inguinal Herniorrhaphy, chronic genital pain, dysejaculation, and sexual dysfunction have only been described sporadically. The aim was therefore to describe these symptoms in a questionnaire study. A nationwide detailed questionnaire study in September 2004 of pain related sexual dysfunction in all men aged 18–40 years undergoing inguinal Herniorrhaphy between October 2002 and June 2003 (n = 1015) based upon the nationwide Danish Hernia Database collaboration. The response rate was 68.4%. Combined frequent and moderate or severe pain from the previous hernia site during activity was reported by 187 patients (18.4%). Pain during sexual activity was reported by 224 patients (22.1%), of which 68 (6.7%) had moderate or severe pain occurring every third time or more. Genital or ejaculatory pain was found in 125 patients (12.3%), and 28 (2.8%) patients reported that the pain impaired their sexual activity to a moderate or severe degree. Pain during sexual activity and subsequent sexual dysfunction represent a clinically significant problem in about 3% of younger male patients with a previous inguinal Herniorrhaphy. Intraoperative nerve damage and disposition to other chronic pain conditions are among the most likely pathogenic factors.
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pain and functional impairment 6 years after inguinal Herniorrhaphy
Hernia, 2006Co-Authors: Eske Kvanner Aasvang, Morten Baynielsen, Henrik KehletAbstract:Pain impairing daily activities following inguinal Herniorrhaphy is reported by about 10% of patients, when asked 1-2 years postoperatively. However, the time course and consequences of postHerniorrhaphy pain is not known in detail. A nationwide follow-up questionnaire study was undertaken 6.5 years postoperatively in 335 well-described patients reporting pain 1 year after inguinal Herniorrhaphy in a previous questionnaire study. Three hundred and three patients, who were alive and could be contacted, received a questionnaire 6.5 years after the Herniorrhaphy. Response rate was 88%. Of 267 patients responding, 57 were analyzed separately due to subsequent inguinal Herniorrhaphy or other major surgery in the observation period, leaving 210 patients (69.3%) for primary analysis. Pain from the previous hernia site was reported by 72 patients (34.3%), and 52 patients (24.8%) reported that pain affected daily activities. Less pain, compared to the 1-year follow-up, was reported by 75.8%, while 16.7% had the same intensity level and 7.5% reported increased pain severity. In the subgroup of patients operated for a recurrence during the observation period and not included in primary analysis, 22 of 44 (50%) still experienced pain at 6.5 years, and 17 (38.6%) reported that pain affected daily activities (mean observation period 4.5 years). Pain after inguinal Herniorrhaphy decreased from about 11% 1 year after surgery, but still affects daily activities in about 6% after 6.5 years. Patients operated for a recurrence are at higher risk for persistent pain.
