Return to outdoor walking, car driving, and sexual activity following elective inguinal hernia repair: surgeons’ perspective versus patients’ reality

Abstract

Purpose

To determine the time to resumption of outdoor walking, car driving, sports, and sexual activity following elective inguinal hernia repair, and to reveal if there are differences between surgeons’ recommendations and patients’ real return times.

Methods

A questionnaire including questions about recommendations to hernia patients for times to resume outdoor walking ability without assistance, driving and sexual intercourse after an elective inguinal hernia repair was sent to surgeons. Also, a short questionnaire was sent to patients who had undergone elective inguinal hernia repair to search the exact times for resuming these physical activities.

Results

Surgeons’ thoughts and recommendations to their patients varied significantly. The range of recommendations were same day to 20 days for outdoor walking, and same day to 3 months both for driving and sexual intercourse. Patients’ actual resumption of postoperative activities were 1–14 days for outdoor walking, 1 day to 3 months for driving, and 1 day to 2 months for sexual intercourse. When the answers from the two questionnaires were compared, it was observed that the mean times for resumption of outdoor walking and sexual intercourse were significantly longer in the patients’ lives than recommended by the surgeons. Patients ≥ 60 years were able to walk outside, drive, and participate in sexual activity earlier than the younger patients. Bilateral and recurrent hernia repairs caused slower resumption of different activities in comparison to primary hernias.

Conclusions

Patients reported that times for resumption of outdoor walking, driving, and sexual activity were significantly longer than those recommended by surgeons. Age, BMI, bilateral repair, and recurrent hernias were found to be factors affecting return time to different activities.

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References

  1. 1.

    Summers JE (1947) Classical herniorrhaphies of Bassini, Halsted and Ferguson. Am J Surg 73:87–99

    CAS  PubMed  Google Scholar 

  2. 2.

    Robertson GS, Burton PR, Haynes IG (1993) How long do patients convalescence after inguinal herniorrhaphy? Current principles and practice. Ann R Coll Surg Engl 75:30–33

    CAS  PubMed  PubMed Central  Google Scholar 

  3. 3.

    Lichtenstein IL, Shore JM (1976) Exploding the myths of hernia repair. Am J Surg 132:307–315

    CAS  PubMed  Google Scholar 

  4. 4.

    Lichtenstein IL (1964) Local anesthesia for hernioplasty: immediate ambulation and return to work: a preliminary report. Calif Med 100:106–109

    CAS  PubMed  PubMed Central  Google Scholar 

  5. 5.

    Bourke JB, Lear PA, Taylor M (1981) Effect of early return to work after elective repair of inguinal hernia: clinical and financial consequences at one year and three years. Lancet 2:623–625

    CAS  PubMed  Google Scholar 

  6. 6.

    Bourke JB, Taylor M (1978) The clinical and economic effects of early return to work after elective inguinal hernia repair. Br J Surg 65:728–731

    CAS  PubMed  Google Scholar 

  7. 7.

    Taylor EW, Dewar EP (1983) Early return to work after repair of a unilateral inguinal hernia. Br J Surg 70:599–600

    CAS  PubMed  Google Scholar 

  8. 8.

    HerniaSurge Group (2018) International guidelines for groin hernia management. Hernia 22:1–165

    Google Scholar 

  9. 9.

    Bay-Nielsen M, Thomsen H, Andersen FH et al (2004) Convalescence after inguinal herniorrhaphy. Br J Surg 91:362–367

    CAS  PubMed  Google Scholar 

  10. 10.

    Grewal P (2014) Survey of post-operative instructions after inguinal hernia repair in England in 2012. Hernia 18:269–272

    CAS  PubMed  Google Scholar 

  11. 11.

    Ismail W, Taylor SJ, Beddow E (2000) Advice on driving after groin hernia surgery in the United Kingdom: questionnaire survey. BMJ 321:1056

    CAS  PubMed  PubMed Central  Google Scholar 

  12. 12.

    Stoker DL, Wellwood JM (1993) Return to work after inguinal hernia repair. Br J Surg 80:1354–1355

    CAS  PubMed  Google Scholar 

  13. 13.

    Boyce DE, Crosby DL, Shandall AA (1995) Aspects of hernia surgery in Wales. Ann R Coll Surg Engl 77:198–201

    CAS  PubMed  PubMed Central  Google Scholar 

  14. 14.

    Kulacoglu H (2018) Comments on the new groin hernia guidelines: what has changed? What has remained unanswered? Turk J Surg 34:83–88

    PubMed  PubMed Central  Google Scholar 

  15. 15.

    Amid PK (2000) Driving after repair of groin hernia. BMJ 321:1033–1034

    CAS  PubMed  PubMed Central  Google Scholar 

  16. 16.

    Wright DM, Hall MG, Paterson CR, O’Dwyer PJ (1999) A randomized comparison of driver reaction time after open and endoscopic tension-free inguinal hernia repair. Surg Endosc 13:332–334

    CAS  PubMed  Google Scholar 

  17. 17.

    Bahir A, Lawaetz O, Kjeldsen L, Lund P (2001) Convalescence and driver reaction time after tension-free inguinal hernia repair. Ambul Surg 9:19–21

    CAS  PubMed  Google Scholar 

  18. 18.

    Welsh CL, Hopton D (1980) Advice about driving after herniorrhaphy. Br Med J 280:1134–1135

    CAS  PubMed  PubMed Central  Google Scholar 

  19. 19.

    Wilson MS, Irving SO, Iddon J, Deans GT, Brough WA (1998) A measurement of the ability to drive after different types of inguinal hernia repair. Surg Laparosc Endosc 8:384–387

    CAS  PubMed  Google Scholar 

  20. 20.

    Sanjay P, Woodward A (2007) A survey of inguinal hernia repair in Wales with special emphasis on laparoscopic repair. Hernia 11:403–407

    CAS  PubMed  Google Scholar 

  21. 21.

    Bischoff JM, Linderoth G, Aasvang EK, Werner MU, Kehlet H (2012) Dysejaculation after laparoscopic inguinal herniorrhaphy: a nationwide questionnaire study. Surg Endosc 26:979–983

    PubMed  Google Scholar 

  22. 22.

    Tolver MA, Rosenberg J (2015) Pain during sexual activity before and after laparoscopic inguinal hernia repair. Surg Endosc 29:3722–3725

    PubMed  Google Scholar 

  23. 23.

    Gutlic N, Petersson U, Rogmark P, Montgomery A (2018) The relevance of sexual dysfunction related to groin pain after inguinal hernia repair—the SexIHQ short form questionnaire assessment. Front Surg 5:15

    PubMed  PubMed Central  Google Scholar 

  24. 24.

    Ertan T, Keskek M, Kilic M, Dizen H, Koc M, Tez M (2007) Recovery of sexual function after scrotal hernia repair. Am J Surg 194:299–303

    PubMed  Google Scholar 

  25. 25.

    Zieren J, Beyersdorff D, Beier KM, Müller JM (2001) Sexual function and testicular perfusion after inguinal hernia repair with mesh. Am J Surg 181:204–206

    CAS  PubMed  Google Scholar 

  26. 26.

    Sönmez MG, Sonbahar BÇ, Bora G, Özalp N, Kara C (2016) Does inguinal hernia repair have an effect on sexual functions? Cent European J Urol 69:212–216

    PubMed  PubMed Central  Google Scholar 

  27. 27.

    Schrenk P, Woisetschläger R, Rieger R, Wayand W (1996) Prospective randomized trial comparing postoperative pain and return to physical activity after transabdominal preperitoneal, total preperitoneal or Shouldice technique for inguinal hernia repair. Br J Surg 83:1563–1566

    CAS  PubMed  Google Scholar 

  28. 28.

    Patterson TJ, Beck J, Currie PJ, Spence RAJ, Spence G (2019) Meta-analysis of patient-reported outcomes after laparoscopic versus open inguinal hernia repair. Br J Surg 106:824–836

    CAS  PubMed  Google Scholar 

  29. 29.

    Li J, Ji Z, Li Y (2014) Comparison of laparoscopic versus open procedure in the treatment of recurrent inguinal hernia: a meta-analysis of the results. Am J Surg 207:602–612

    PubMed  Google Scholar 

  30. 30.

    EU Hernia Trialists Collaboration (2000) Laparoscopic compared with open methods of groin hernia repair: systematic review of randomized controlled trials. Br J Surg 87:860–867

    Google Scholar 

  31. 31.

    Fujita F, Lahmann B, Otsuka K, Lyass S, Hiatt JR, Phillips EH (2004) Quantification of pain and satisfaction following laparoscopic and open hernia repair. Arch Surg 139:596–600

    PubMed  Google Scholar 

  32. 32.

    Patel M, Garcea G, Fairhurst K, Dennison AR (2012) Patient perception of laparoscopic versus open mesh repair of inguinal hernia, the hard sell. Hernia 16:411–415

    CAS  PubMed  Google Scholar 

  33. 33.

    Griffiths M, Oblin ME, Acheson ED (1979) Sickness absence after inguinal herniorrhaphy. J Epidemiol Community Health 33:121–126

    CAS  PubMed  PubMed Central  Google Scholar 

  34. 34.

    Moore AR, Clinch D (2004) Underlying mechanisms of impaired visceral pain perception in older people. J Am Geriatr Soc 52:132–136

    PubMed  Google Scholar 

  35. 35.

    Gibson SJ, Helme RD (2001) Age-related differences in pain perception and report. Clin Geriatr Med 17:433–456

    CAS  PubMed  Google Scholar 

  36. 36.

    Siddaiah-Subramanya M, Ashrafi D, Memon B, Memon MA (2018) Causes of recurrence in laparoscopic inguinal hernia repair. Hernia 22:975–986

    PubMed  Google Scholar 

  37. 37.

    Schjøth-Iversen L, Refsum A, Brudvik KW (2017) Factors associated with hernia recurrence after laparoscopic total extraperitoneal repair for inguinal hernia: a 2-year prospective cohort study. Hernia 21:729–735

    PubMed  Google Scholar 

  38. 38.

    Ashrafi D, Siddaiah-Subramanya M, Memon B, Memon MA (2018) Causes of recurrences after open inguinal herniorrhaphy. Hernia. https://doi.org/10.1007/s10029-018-1868-z

    Article  PubMed  Google Scholar 

  39. 39.

    Niebuhr H, Wegner F, Hukauf M, Lechner M, Fortelny R, Bittner R, Schug-Pass C, Köckerling F (2018) What are the influencing factors for chronic pain following TAPP inguinal hernia repair: an analysis of 20,004 patients from the Herniamed Registry. Surg Endosc 32:1971–1983

    CAS  PubMed  Google Scholar 

  40. 40.

    Willoughby AD, Lim RB, Lustik MB (2017) Open versus laparoscopic unilateral inguinal hernia repairs: defining the ideal BMI to reduce complications. Surg Endosc 31:206–214

    PubMed  Google Scholar 

  41. 41.

    Serpell JW, Johnson CD, Jarrett PE (1990) A prospective study of bilateral inguinal hernia repair. Ann R Coll Surg Engl 72:299–303

    CAS  PubMed  PubMed Central  Google Scholar 

  42. 42.

    Sarli L, Iusco DR, Sansebastiano G, Costi R (2001) Simultaneous repair of bilateral inguinal hernias: a prospective, randomized study of open, tension-free versus laparoscopic approach. Surg Laparosc Endosc Percutan Tech 11:262–267

    CAS  PubMed  Google Scholar 

  43. 43.

    Kald A, Domeij E, Landin S, Wirén M, Anderberg B (2000) Laparoscopic hernia repair in patients with bilateral groin hernias. Eur J Surg 166:210–212

    CAS  PubMed  Google Scholar 

  44. 44.

    Lal P, Philips P, Chander J, Ramteke VK (2010) Is unilateral laparoscopic TEP inguinal hernia repair a job half done? The case for bilateral repair. Surg Endosc 24:1737–1745

    Google Scholar 

  45. 45.

    Payne JH Jr, Grininger LM, Izawa MT, Podoll EF, Lindahl PJ, Balfour J (1994) Laparoscopic or open inguinal herniorrhaphy? A randomized prospective trial. Arch Surg 129:973–979

    PubMed  Google Scholar 

  46. 46.

    Tolver MA, Rosenberg J, Bisgaard T (2016) Convalescence after laparoscopic inguinal hernia repair: a qualitative systematic review. Surg Endosc 30:5165–5172

    PubMed  Google Scholar 

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Correspondence to H. Kulacoglu.

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This study including human participants has been performed in accordance with the ethical standards of the Declaration of Helsinki and its later amendments.

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This study was approved by the Ethics Committee of Lokman Hekim University.

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Kulacoglu, H., Celasin, H. & Karaca, A.S. Return to outdoor walking, car driving, and sexual activity following elective inguinal hernia repair: surgeons’ perspective versus patients’ reality. Hernia (2020). https://doi.org/10.1007/s10029-020-02255-x

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Keywords

  • Inguinal hernia
  • TEP
  • Lichtenstein repair
  • Postoperative
  • Convalescence