A Novel One-Stop Multidisciplinary Clinic for Chronic Postoperative Inguinal Pain: Initial Experiences and Outcomes
BackgroundChronic Postoperative Inguinal Pain (CPIP) affects 10%–20% of patients following inguinal hernia repair, persisting for over 3 months post-surgery. It involves a complex interplay of neuropathic and nociceptive pain, secondary sensitization, and functional and psychological impacts. The co...
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Frontiers Media S.A.
2025-06-01
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| Series: | Journal of Abdominal Wall Surgery |
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| Online Access: | https://www.frontierspartnerships.org/articles/10.3389/jaws.2025.14317/full |
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| author | Federica Cocciolo Alice Birch Maciej Pawlak Lucy Miller Alan Bennett Matthew Lund David Sanders John M. Findlay John M. Findlay John M. Findlay |
| author_facet | Federica Cocciolo Alice Birch Maciej Pawlak Lucy Miller Alan Bennett Matthew Lund David Sanders John M. Findlay John M. Findlay John M. Findlay |
| author_sort | Federica Cocciolo |
| collection | DOAJ |
| description | BackgroundChronic Postoperative Inguinal Pain (CPIP) affects 10%–20% of patients following inguinal hernia repair, persisting for over 3 months post-surgery. It involves a complex interplay of neuropathic and nociceptive pain, secondary sensitization, and functional and psychological impacts. The condition often coexists with other pain causes, complicating diagnosis and treatment. Despite recommendations for multidisciplinary management, diagnostic and treatment pathways are frequently fragmented.ObjectiveThis study evaluated the efficacy of a one-stop multidisciplinary clinic for CPIP in improving patient-reported outcomes (PROMS) and satisfaction.MethodsA one-stop multidisciplinary clinic was established at the North Devon Comprehensive Hernia Centre, involving an Abdominal Wall Surgeon, Advanced Clinical Practitioners, Pain Management Consultants, and Pain Specialist Physiotherapists. Following a remote ACP assessment, patients underwent 45-minute evaluations by a surgeon, pain specialist, and physiotherapist, culminating in an MDT discussion and a personalized management plan. Data were retrospectively collected for patients reviewed between July 2021 and July 2022, including demographics, surgical history, CPIP diagnoses, treatments, and PROMS.ResultsForty patients underwent MDT assessment; 55% pursued further treatment. Among 19 patients with follow-up data, 26% underwent surgery, 35% invasive non-surgical treatments, and 39% pharmacological therapies combined with physiotherapy and psychological support. Pain scores (VAS) decreased from 7.2 to 2.8, and functional activity (mAAS) improved from 20.3 to 9.7 (p < 0.0001). Patient satisfaction was high (mean score: 4.5/5).ConclusionThe one-stop multidisciplinary clinic significantly improved pain, function, and satisfaction, highlighting its value for CPIP management. Larger studies with delayed follow-up are needed to validate these findings. |
| format | Article |
| id | doaj-art-291a1fe8fe0d4a27bad195171eaaa37f |
| institution | DOAJ |
| issn | 2813-2092 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Journal of Abdominal Wall Surgery |
| spelling | doaj-art-291a1fe8fe0d4a27bad195171eaaa37f2025-08-20T03:20:08ZengFrontiers Media S.A.Journal of Abdominal Wall Surgery2813-20922025-06-01410.3389/jaws.2025.1431714317A Novel One-Stop Multidisciplinary Clinic for Chronic Postoperative Inguinal Pain: Initial Experiences and OutcomesFederica Cocciolo0Alice Birch1Maciej Pawlak2Lucy Miller3Alan Bennett4Matthew Lund5David Sanders6John M. Findlay7John M. Findlay8John M. Findlay9Academic Department of Abdominal Wall and Upper Gastrointestinal Surgery, North Devon District Hospital, Royal Devon University Healthcare NHS Foundation Trust, Barnstaple, United KingdomAcademic Department of Abdominal Wall and Upper Gastrointestinal Surgery, North Devon District Hospital, Royal Devon University Healthcare NHS Foundation Trust, Barnstaple, United KingdomDepartment of Abdominal Wall Surgery, Golden Jubilee National University Hospital, Clydebank, United KingdomDepartment of Anaesthetics and Pain Management, North Devon District Hospital, Royal Devon University Healthcare NHS Foundation Trust, Barnstaple, United KingdomDepartment of Anaesthetics and Pain Management, North Devon District Hospital, Royal Devon University Healthcare NHS Foundation Trust, Barnstaple, United KingdomDepartment of Anaesthetics and Pain Management, North Devon District Hospital, Royal Devon University Healthcare NHS Foundation Trust, Barnstaple, United KingdomDepartment of Anaesthetics and Pain Management, North Devon District Hospital, Royal Devon University Healthcare NHS Foundation Trust, Barnstaple, United KingdomAcademic Department of Abdominal Wall and Upper Gastrointestinal Surgery, North Devon District Hospital, Royal Devon University Healthcare NHS Foundation Trust, Barnstaple, United KingdomDepartment of Clinical and Biomedical Sciences, University of Exeter Medical School, University of Exeter, St Luke’s Campus, Exeter, United KingdomNIHR Exeter Biomedical Research Centre, University of Exeter Medical School, University of Exeter, St Luke’s Campus, Exeter, United KingdomBackgroundChronic Postoperative Inguinal Pain (CPIP) affects 10%–20% of patients following inguinal hernia repair, persisting for over 3 months post-surgery. It involves a complex interplay of neuropathic and nociceptive pain, secondary sensitization, and functional and psychological impacts. The condition often coexists with other pain causes, complicating diagnosis and treatment. Despite recommendations for multidisciplinary management, diagnostic and treatment pathways are frequently fragmented.ObjectiveThis study evaluated the efficacy of a one-stop multidisciplinary clinic for CPIP in improving patient-reported outcomes (PROMS) and satisfaction.MethodsA one-stop multidisciplinary clinic was established at the North Devon Comprehensive Hernia Centre, involving an Abdominal Wall Surgeon, Advanced Clinical Practitioners, Pain Management Consultants, and Pain Specialist Physiotherapists. Following a remote ACP assessment, patients underwent 45-minute evaluations by a surgeon, pain specialist, and physiotherapist, culminating in an MDT discussion and a personalized management plan. Data were retrospectively collected for patients reviewed between July 2021 and July 2022, including demographics, surgical history, CPIP diagnoses, treatments, and PROMS.ResultsForty patients underwent MDT assessment; 55% pursued further treatment. Among 19 patients with follow-up data, 26% underwent surgery, 35% invasive non-surgical treatments, and 39% pharmacological therapies combined with physiotherapy and psychological support. Pain scores (VAS) decreased from 7.2 to 2.8, and functional activity (mAAS) improved from 20.3 to 9.7 (p < 0.0001). Patient satisfaction was high (mean score: 4.5/5).ConclusionThe one-stop multidisciplinary clinic significantly improved pain, function, and satisfaction, highlighting its value for CPIP management. Larger studies with delayed follow-up are needed to validate these findings.https://www.frontierspartnerships.org/articles/10.3389/jaws.2025.14317/fullchronic postoperative inguinal pain (CPIP)multidisciplinary clinicpatient-reported outcomes (PROMS)hernia surgery complicationspain management |
| spellingShingle | Federica Cocciolo Alice Birch Maciej Pawlak Lucy Miller Alan Bennett Matthew Lund David Sanders John M. Findlay John M. Findlay John M. Findlay A Novel One-Stop Multidisciplinary Clinic for Chronic Postoperative Inguinal Pain: Initial Experiences and Outcomes Journal of Abdominal Wall Surgery chronic postoperative inguinal pain (CPIP) multidisciplinary clinic patient-reported outcomes (PROMS) hernia surgery complications pain management |
| title | A Novel One-Stop Multidisciplinary Clinic for Chronic Postoperative Inguinal Pain: Initial Experiences and Outcomes |
| title_full | A Novel One-Stop Multidisciplinary Clinic for Chronic Postoperative Inguinal Pain: Initial Experiences and Outcomes |
| title_fullStr | A Novel One-Stop Multidisciplinary Clinic for Chronic Postoperative Inguinal Pain: Initial Experiences and Outcomes |
| title_full_unstemmed | A Novel One-Stop Multidisciplinary Clinic for Chronic Postoperative Inguinal Pain: Initial Experiences and Outcomes |
| title_short | A Novel One-Stop Multidisciplinary Clinic for Chronic Postoperative Inguinal Pain: Initial Experiences and Outcomes |
| title_sort | novel one stop multidisciplinary clinic for chronic postoperative inguinal pain initial experiences and outcomes |
| topic | chronic postoperative inguinal pain (CPIP) multidisciplinary clinic patient-reported outcomes (PROMS) hernia surgery complications pain management |
| url | https://www.frontierspartnerships.org/articles/10.3389/jaws.2025.14317/full |
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