Hernias as a Cause of Chronic Pelvic Pain in Women

BACKGROUND Chronic pelvic pain in women due to hernias may be misdiagnosed by practicing clinicians. These fascial defects, their symptoms, physical findings, and proper treatment must be known in order to help women experiencing this form of chronic pelvic pain. METHODS All procedures were performed by the primary author using standard laparoscopic tension-free mesh techniques. RESULTS The study included 264 patients referred to a chronic pelvic pain clinic, who underwent 386 laparoscopic surgical repairs of hernial defects. Ninety percent of the patients underwent concomitant procedures appropriate for their multiple pain generators. Length of follow-up is 1.53 years (range, 2 months to 5.5 years). Evaluation of patients' pain component from the repaired hernia was recorded. There have been no recurrences. One persistent ilioinguinal neuropathy from an inguinal hernia repair (.4%) has occurred. All other patients received relief of their hernia pain (99.6%). Four complications from concomitant surgeries (1.5%) are reported. CONCLUSIONS Laparoscopic treatment of hernia pain in women is effective in relieving chronic pain and has a low recurrence and complication rate in the hands of experienced laparoscopists.