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Purpose: To determine whether levels of pre-operative pain as recalled by a patient in the post-operative phase are possibly overestimated or underestimated compared to prospectively scored pain levels. If so, a subsequent misclassification may induce recall bias that may lead to an erroneous effect outcome., Methods: Data of seven retrospective cohort studies on surgery for chronic abdominal wall and groin pain using three different pain scores were systematically analyzed. First, it was assessed whether retrospectively acquired pre-operative pain levels, as scored by the patient in the post-operative phase, differed from prospectively obtained pre-operative pain scores. Second, it was determined if errors associated with retrospectively obtained pain scores potentially lead to a misclassification of treatment outcome. Third, a meta-analysis established whether recall misclassifications, if present, affected overall study conclusions., Results: Pain data of 313 patients undergoing remedial surgery were evaluated. The overall prevalence of misclassification due to a recall error was 13.7%. Patients not benefitting from surgery ('failures') judged their pre-operative pain level as more severe than it actually was. In contrast, patients who were pain free after remedial surgery ('successes') underestimated pre-operative pain scores. Recall misclassifications were significantly more present in failures than in successful patients (odds ratio 2.4 [95% CI 1.2-4.8])., Conclusion: One in seven patients undergoing remedial groin surgery is misclassified on the basis of retrospectively obtained pre-operative pain scores (success instead of failure, or vice versa). Misclassifications are relatively more present in failures after surgery. Therefore, the effect size of a therapy erroneously depends on its success rate., (© 2022. The Author(s), under exclusive licence to Springer-Verlag France SAS, part of Springer Nature.)

Objective: The aim of this study was to investigate long-term groin pain and inguinal hernia recurrence rates of 2 types of mesh and to describe the evolution of postoperative groin sensory disturbances., Summary of Background Data: Some patients with an inguinal hernia develop chronic pain following open mesh insertion. Previous trials comparing a semi-resorbable, self-gripping Progrip mesh with a standard sutured polypropylene mesh found conflicting results regarding recurrence rates and residual groin pain., Methods: Patients aged >18 years scheduled for open primary hernia repair were randomized to a self-gripping mesh (Progrip) or a polypropylene mesh (standard). Removal of the inguinal nerves was left to the discretion of the surgeon. Pain was measured using Visual Analogue Scale (VAS) over a 3-year period. Pain characteristics and hernia recurrences were determined using physical examination., Results: Data of 274 patients were complete (75% three-year follow-up rate). Pain steadily decreased over time in both groups in a similar fashion (moderate pain 3.7% in each group). Hyperesthesia was experienced by 2.2% and 3.7% and hypoesthesia in 12% and 19% in Progrip and standard group, respectively. One of seven Progrip patients reported a foreign body feeling versus 1 of 5 standard patients (P = 0.06). Altered skin sensations were not related to a neurectomy. Hernia recurrence rate was 11.5% in the Progrip and 5% in the standard group (P = 0.05)., Conclusions: Three years after insertion of a self-gripping Progrip mesh or a sutured polypropylene mesh for an open primary inguinal hernia repair, groin pain is minimal, although altered groin skin sensations and foreign body feeling are quite common. A Progrip hernia repair is associated with a high recurrence rate.