Pain after hernia repair is an important issue that affects a small but significant number of patients following surgery. While the majority of people recover quickly and return to normal activities within weeks, some experience ongoing discomfort or persistent pain in the groin or abdominal wall. Understanding why this occurs and how it can be treated is a specialised area of hernia surgery that requires both experience and a deep understanding of the anatomy of the abdominal wall.
After hernia repair, some degree of discomfort is normal. Surgical repair involves reinforcing the abdominal wall, often with mesh, and this process creates inflammation and tissue healing that can cause temporary soreness. For most patients this settles steadily over the first few weeks to months. However, in a small proportion of cases pain persists longer than expected. This is sometimes referred to as chronic postoperative inguinal pain or abdominal wall pain.
Persistent pain after hernia surgery can arise for several reasons. The nerves that run through the groin and abdominal wall are extremely small and delicate, and during hernia repair they may become irritated, trapped in scar tissue, or compressed by sutures or mesh. In some cases, the pain is due to nerve entrapment syndromes such as anterior cutaneous nerve entrapment syndrome (ACNES) or abdominal wall nerve entrapment syndrome (AWNES). Other patients may develop mesh-related irritation or scar tissue that affects surrounding structures. Because these conditions can mimic other causes of abdominal or groin pain, careful diagnosis is essential.
Assessment usually begins with a detailed clinical history and examination. Many patients have already undergone multiple scans or tests before the true cause of their pain is identified. Imaging such as ultrasound or MRI can sometimes help, but in many cases the key to diagnosis lies in understanding the pattern of pain and identifying specific trigger points along the abdominal wall. Local anaesthetic injections may be used both diagnostically and therapeutically to confirm that a nerve is responsible for the pain.
Treatment depends on the underlying cause. Some patients improve with conservative management such as physiotherapy, targeted injections, or medications that calm nerve irritation. When pain is caused by a trapped or damaged nerve, specialised surgical procedures may be required to release or remove the affected nerve. In many cases revision surgery or mesh removal may be necessary.
In Australia, one of the surgeons most recognised for expertise in this complex area is Associate Professor Hugh McGregor. He is widely regarded as one of the country’s leading specialists in hernia surgery and chronic postoperative pain following hernia repair. Associate Professor McGregor has extensive experience in all facets of hernia repair and the management of difficult complications that may occur afterwards.
His practice focuses on minimally invasive hernia repair, advanced abdominal wall surgery, including the diagnosis and treatment of nerve entrapment syndromes and persistent pain after hernia operations. Through a combination of careful clinical assessment, modern surgical techniques, and a strong research interest in chronic pain, Associate Professor McGregor provides patients with access to specialised care that is not widely available elsewhere in Australia.
For patients experiencing ongoing discomfort after hernia surgery, expert evaluation is essential. With the right diagnosis and treatment, many individuals who have struggled with chronic pain can achieve significant relief and return to normal activities. Associate Professor Hugh McGregor’s work in this field continues to improve understanding of post-hernia repair pain and offers hope to patients seeking effective solutions.