{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T11:40:01Z","timestamp":1792496401395,"version":"4.5.0"},"reference-count":32,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2016,11,4]],"date-time":"2016-11-04T00:00:00Z","timestamp":1478217600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2016,11,4]],"date-time":"2016-11-04T00:00:00Z","timestamp":1478217600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2017,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Some patients with persistent inguinodynia following a Lichtenstein hernia repair fail all non\u2010surgical treatments. Characteristics of mesh\u2010related pain are not well described whereas a meshectomy is controversial. Aims were to define mesh\u2010related pain symptoms, to investigate long\u2010term effects of a meshectomy and to provide recommendations on meshectomy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Consecutive patients undergoing open meshectomy with\/without selective neurectomy for chronic inguinodynia following Lichtenstein repair were analysed including a follow\u2010up questionnaire. Outcome measures were complications, satisfaction (excellent, good, moderate, poor) and hernia recurrence rate. Recommendations for meshectomy are proposed based on a literature review.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Seventy\u2010four patients (67\u00a0males, median age 56 years) underwent mesh removal (exclusively mesh, 26%; combined with tailored neurectomy, 74%) between June 2006 and March 2015\u00a0in a single centre. Complications were intraoperatively recognized small bowel injury (<jats:italic>n<\/jats:italic> = 1) and testicular atrophy (<jats:italic>n<\/jats:italic> = 2). A 64% excellent\/good long\u2010term result was attained (median 18\u00a0months). Success rates of a meshectomy (63%) or combined with a neurectomy (64%) were similar. Five hernia recurrences occurred during follow\u2010up (7%). A patient with a pure mesh\u2010related groin pain characteristically reports a \u2018foreign body feeling\u2019. Pain intensifies during hip flexion (car driving) and is attenuated following hip extension or supine position. Palpation is painful along the inguinal ligament whereas neuropathic characteristics (hyperpathic skin, trigger points) are lacking.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Mesh removal either or not combined with tailored neurectomy is beneficial in two of three patients with characteristics of mesh\u2010related inguinodynia following Lichtenstein hernia repair who are refractory to alternative pain treatments.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-016-3780-y","type":"journal-article","created":{"date-parts":[[2016,11,4]],"date-time":"2016-11-04T16:43:06Z","timestamp":1478277786000},"page":"701-712","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":41,"title":["Mesh Removal and Selective Neurectomy for Persistent Groin Pain Following Lichtenstein Repair"],"prefix":"10.1002","volume":"41","author":[{"given":"Willem A. R.","family":"Zwaans","sequence":"first","affiliation":[{"name":"Department of General Surgery M\u00e1xima Medical Centre De Run 4600, P.O. Box 7777 5500 MB Veldhoven\/Eindhoven The Netherlands"},{"name":"Centre of Excellence for Abdominal Wall and Groin Pain SolviM\u00e1x Eindhoven The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christel W.","family":"Perquin","sequence":"additional","affiliation":[{"name":"Centre of Excellence for Abdominal Wall and Groin Pain SolviM\u00e1x Eindhoven The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maarten J. A.","family":"Loos","sequence":"additional","affiliation":[{"name":"Department of General Surgery M\u00e1xima Medical Centre De Run 4600, P.O. Box 7777 5500 MB Veldhoven\/Eindhoven The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rudi M. 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