Pain related sexual dysfunction after inguinal herniorrhaphy

TLDR

Chronic genital pain, dysejaculation, and sexual dysfunction after inguinal herniorrhaphy are rarely reported, unlike the well‑described ~10% risk of chronic wound pain. The study aimed to determine the incidence of pain‑related sexual dysfunction one year after inguinal herniorrhaphy and to assess its impact on sexual function via questionnaire. A nationwide questionnaire of 1015 men aged 18‑40 who underwent inguinal herniorrhaphy between Oct 2002 and Jun 2003, based on the Danish Hernia Database, was conducted in September 2004. Among 1015 men (68.4% response), 18.4% reported frequent or severe pain during activity, 22.1% experienced pain during sexual activity (6.7% moderate/severe), 12.3% had genital or ejaculatory pain (2.8% moderate/severe), and about 3% suffered pain‑related sexual dysfunction, with intraoperative nerve injury and a tendency toward other chronic pain conditions identified as likely causes.

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.