{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T16:15:24Z","timestamp":1789143324628,"version":"build-2803163510"},"reference-count":24,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T00:00:00Z","timestamp":1789084800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T00:00:00Z","timestamp":1789084800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Surg Endosc"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Although nearly half of elective ventral hernias are repaired in women, the literature on sex-specific disparities in postoperative complications and quality of life is limited. Understanding these differences is critical to setting patient expectations, informing risk counseling, and providing goal-concordant care. We opted to explore the influence of patient sex on postoperative outcomes and patient-reported quality of life using a national registry.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective cohort study was conducted using data from the Abdominal Core Health Quality Collaborative (ACHQC) Registry. Adult (\u2265\u200918\u00a0years) patients who underwent elective ventral hernia repair from 1\/2012 to 12\/2023 were included if sex, operative data, and 30-day follow-up were complete. The primary outcome was postoperative complications. Secondary outcomes included patient-reported quality of life measured by the Hernia-Related Quality-of-Life Survey (HerQLes) and Patient-Reported Outcomes Measurement Information System (PROMIS) pain scores. The Kruskal-Wallis test was used for continuous variables, and\u00a0the Pearson test\u00a0was used for categorical variables.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 32,956 patients who underwent ventral hernia repair, 15,395 (46.7%) were female. Females had higher rates of readmission (3.2% vs. 2.5%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), wound-related readmission (1.1% vs. 0.6%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), SSIs (2.4% vs. 1.6%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), SSIs requiring debridement (0.5% vs. 0.2%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.02), pain requiring intervention (0.4% vs. 0.1%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), 2- and 3-year pragmatic hernia recurrence (19.2% vs. 15.5%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001 and 21% vs. 17.6%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01), and OR duration\u2009&gt;\u20092\u00a0h (45% vs. 33%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Despite this, females demonstrated more robust changes in HerQLes scores from baseline to 30\u00a0days (median 10 vs. 6.70,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and more notable changes in PROMIS pain T-scores from baseline to 1\u00a0year (median -2 vs. -1,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). After multivariable analysis, female sex was associated with lower HerQLes scores at\u00a01\u00a0year (\n                      <jats:italic>\u00df<\/jats:italic>\n                      \u2009=\u2009-1.83,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.037) and higher PROMIS pain scores at 30\u00a0days and 1\u00a0year (\n                      <jats:italic>\u00df<\/jats:italic>\n                      \u2009=\u20090.35 and 0.47, respectively; both\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Female sex is associated with higher rates of postoperative complications but greater unadjusted improvement in patient-reported outcomes with worse adjusted postoperative quality of life and pain. These findings emphasize a discordance between clinical and patient-centered outcomes, suggesting that both should be considered when counseling patients and defining surgical success.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00464-026-13217-2","type":"journal-article","created":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T15:55:37Z","timestamp":1789142137000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Women have more complications but better reported quality of life after elective ventral hernia repair"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-7096-0942","authenticated-orcid":false,"given":"Ashley M.","family":"Aldridge","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marisa H.","family":"Blackman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Courtney E.","family":"Collins","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,11]]},"reference":[{"issue":"1","key":"13217_CR1","doi-asserted-by":"publisher","first-page":"241","DOI":"10.1007\/s00464-020-07386-x","volume":"35","author":"FA Guzman Pruneda","year":"2021","unstructured":"Guzman Pruneda FA, Huang LC, Collins C, Renshaw S, Narula V, Poulose BK (2021) Abdominal core quality of life after ventral hernia repair a comparison of open versus robotic-assisted retromuscular techniques. Surg Endosc 35(1):241\u2013248. https:\/\/doi.org\/10.1007\/s00464-020-07386-x","journal-title":"Surg Endosc"},{"issue":"2","key":"13217_CR2","doi-asserted-by":"publisher","first-page":"179","DOI":"10.1007\/s10029-011-0879-9","volume":"16","author":"BK Poulose","year":"2012","unstructured":"Poulose BK, Shelton J, Phillips S, Moore D, Nealon W, Penson D et al (2012) Epidemiology and cost of ventral hernia repair: making the case for hernia research. Hernia 16(2):179\u2013183. https:\/\/doi.org\/10.1007\/s10029-011-0879-9","journal-title":"Hernia"},{"issue":"5","key":"13217_CR3","doi-asserted-by":"publisher","first-page":"995","DOI":"10.1007\/s10029-019-02015-6","volume":"23","author":"THJ Lee","year":"2019","unstructured":"Lee THJ, Ulisney KL, Choudhuri AK, Swiger JL, Gibeily GJ (2019) Understanding the patient perspective after ventral hernia repair. Hernia 23(5):995\u20131001. https:\/\/doi.org\/10.1007\/s10029-019-02015-6","journal-title":"Hernia"},{"issue":"4","key":"13217_CR4","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1177\/000313481608200408","volume":"82","author":"P Craig","year":"2016","unstructured":"Craig P, Parikh PP, Markert R, Saxe J (2016) Prevalence and predictors of hernia infection: does gender matter? Am Surg 82(4):93\u201395. https:\/\/doi.org\/10.1177\/000313481608200408","journal-title":"Am Surg"},{"issue":"3","key":"13217_CR5","doi-asserted-by":"publisher","first-page":"501","DOI":"10.1016\/j.amjsurg.2016.02.021","volume":"212","author":"TC Cox","year":"2016","unstructured":"Cox TC, Huntington CR, Blair LJ, Prasad T, Lincourt AE, Heniford BT, Augenstein VA (2016) Predictive modeling for chronic pain after ventral hernia repair. Am J Surg 212(3):501\u2013510. https:\/\/doi.org\/10.1016\/j.amjsurg.2016.02.021","journal-title":"Am J Surg"},{"issue":"5","key":"13217_CR6","doi-asserted-by":"publisher","first-page":"1158","DOI":"10.1016\/j.surg.2020.11.003","volume":"169","author":"H Ciomperlik","year":"2021","unstructured":"Ciomperlik H, Dhanani NH, Cassata N, Mohr C, Bernardi K, Holihan JL et al (2021) Patient quality of life before and after ventral hernia repair. Surgery 169(5):1158\u20131163. https:\/\/doi.org\/10.1016\/j.surg.2020.11.003","journal-title":"Surgery"},{"key":"13217_CR7","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-017-4173-6","author":"DV Cherla","year":"2018","unstructured":"Cherla DV, Moses ML, Viso CP, Holihan JL, Flores-Gonzalez JR, Kao LS et al (2018) Impact of abdominal wall hernias and repair on patient quality of life. World J Surg. https:\/\/doi.org\/10.1007\/s00268-017-4173-6","journal-title":"World J Surg"},{"issue":"3","key":"13217_CR8","doi-asserted-by":"publisher","first-page":"614","DOI":"10.1016\/j.surg.2019.11.016","volume":"167","author":"KA Schlosser","year":"2020","unstructured":"Schlosser KA, Maloney SR, Thielan O, Prasad T, Kercher K, Colavita PD, Heniford BT, Augenstein VA (2020) Outcomes specific to patient sex after open ventral hernia repair. Surgery 167(3):614\u2013619. https:\/\/doi.org\/10.1016\/j.surg.2019.11.016","journal-title":"Surgery"},{"issue":"3","key":"13217_CR9","doi-asserted-by":"publisher","first-page":"567","DOI":"10.1007\/s10029-019-02089-2","volume":"24","author":"F K\u00f6ckerling","year":"2020","unstructured":"K\u00f6ckerling F, Hoffmann H, Adolf D, Weyhe D, Reinpold W, Koch A et al (2020) Female sex as independent risk factor for chronic pain following elective incisional hernia repair: registry-based, propensity score-matched comparison. Hernia 24(3):567\u2013576. https:\/\/doi.org\/10.1007\/s10029-019-02089-2","journal-title":"Hernia"},{"issue":"11","key":"13217_CR10","doi-asserted-by":"publisher","first-page":"5023","DOI":"10.1007\/s00464-016-4850-9","volume":"30","author":"O Langbach","year":"2016","unstructured":"Langbach O, Bukholm I, Benth J\u0160, R\u00f8kke O (2016) Long-term quality of life and functionality after ventral hernia mesh repair. Surg Endosc 30(11):5023\u20135033. https:\/\/doi.org\/10.1007\/s00464-016-4850-9","journal-title":"Surg Endosc"},{"issue":"3","key":"13217_CR11","doi-asserted-by":"publisher","first-page":"685","DOI":"10.1007\/s10029-022-02634-6","volume":"26","author":"G Campanelli","year":"2022","unstructured":"Campanelli G (2022) Quality of life is the most important outcome measure of hernia repair. Hernia 26(3):685. https:\/\/doi.org\/10.1007\/s10029-022-02634-6","journal-title":"Hernia"},{"issue":"3","key":"13217_CR12","doi-asserted-by":"publisher","first-page":"1927","DOI":"10.1007\/s00464-021-08475-1","volume":"36","author":"CE Collins","year":"2022","unstructured":"Collins CE, Renshaw S, Gupta A, Santry H, Poulose BK (2022) Elective ventral hernia repair provides significant abdominal wall quality of life improvements in older patients. Surg Endosc 36(3):1927\u20131935. https:\/\/doi.org\/10.1007\/s00464-021-08475-1","journal-title":"Surg Endosc"},{"key":"13217_CR13","unstructured":"Abdominal Core Health Quality Collaborative (ACHQC) (n.d.) About us. Available from: https:\/\/achqc.org\/faqs. Cited 2026 Mar 14."},{"issue":"10","key":"13217_CR14","doi-asserted-by":"publisher","first-page":"6793","DOI":"10.1007\/s00464-025-12060-1","volume":"39","author":"SA Lewis","year":"2025","unstructured":"Lewis SA, Huang LC, Al-Mansour MR (2025) Quality of life outcomes of minimally invasive repair of occult contralateral inguinal hernias: an ACHQC analysis. Surg Endosc 39(10):6793\u20136801. https:\/\/doi.org\/10.1007\/s00464-025-12060-1","journal-title":"Surg Endosc"},{"issue":"6","key":"13217_CR15","doi-asserted-by":"publisher","first-page":"4869","DOI":"10.1007\/s00464-022-09587-y","volume":"37","author":"SM Renshaw","year":"2023","unstructured":"Renshaw SM, Olson MA, Poulose BK, Collins CE (2023) Community distress as a predictor of early hernia recurrence for older adults undergoing ventral hernia repair (VHR). Surg Endosc 37(6):4869\u20134876. https:\/\/doi.org\/10.1007\/s00464-022-09587-y","journal-title":"Surg Endosc"},{"issue":"12","key":"13217_CR16","doi-asserted-by":"publisher","first-page":"1085","DOI":"10.1001\/jamasurg.2021.4309","volume":"156","author":"DM Krpata","year":"2021","unstructured":"Krpata DM, Petro CC, Prabhu AS, Tastaldi L, Zolin S, Fafaj A et al (2021) Effect of hernia mesh weights on postoperative patient-related and clinical outcomes after open ventral hernia repair: a randomized clinical trial. JAMA Surg 156(12):1085. https:\/\/doi.org\/10.1001\/jamasurg.2021.4309","journal-title":"JAMA Surg"},{"issue":"5","key":"13217_CR17","doi-asserted-by":"publisher","first-page":"635","DOI":"10.1016\/j.jamcollsurg.2012.06.412","volume":"215","author":"DM Krpata","year":"2012","unstructured":"Krpata DM, Schmotzer BJ, Flocke S, Jin J, Blatnik JA, Ermlich B et al (2012) Design and initial implementation of HerQLes: a hernia-related quality-of-life survey to assess abdominal wall function. J Am Coll Surg 215(5):635\u2013642. https:\/\/doi.org\/10.1016\/j.jamcollsurg.2012.06.412","journal-title":"J Am Coll Surg"},{"key":"13217_CR18","unstructured":"HealthMeasures (2025) PROMIS measures collected in routine clinical care at a children's hospital. Available from: https:\/\/www.healthmeasures.net\/explore-measurement-systems\/promis. Cited 2026 Mar 14."},{"key":"13217_CR19","unstructured":"HealthMeasures (2020) PROMIS - Pain intensity - A brief guide to the PROMIS\u00ae Pain Intensity instruments. Available from: https:\/\/www.healthmeasures.net\/images\/PROMIS\/manuals\/PROMIS_Pain_Intensity_Scoring_Manual.pdf. Cited 2026 Mar 14."},{"key":"13217_CR20","unstructured":"HealthMeasures (n.d.) PROMIS. Available from: https:\/\/www.healthmeasures.net\/score-and-interpret\/interpret-scores\/promis. Cited 2026 Mar 14."},{"key":"13217_CR21","unstructured":"R: The R Project for Statistical Computing. Available from: https:\/\/www.r-project.org\/. Cited 2026 Mar 14."},{"issue":"1","key":"13217_CR22","doi-asserted-by":"publisher","first-page":"181","DOI":"10.1007\/s10029-025-03371-2","volume":"29","author":"LJ Schoel","year":"2025","unstructured":"Schoel LJ, Sinamo J, Hallway A, Fry BT, Fischer JP, O\u2019Neill SM et al (2025) Impact of surgical approach on complications by sex following ventral and incisional hernia repair. Hernia 29(1):181. https:\/\/doi.org\/10.1007\/s10029-025-03371-2","journal-title":"Hernia"},{"issue":"11","key":"13217_CR23","doi-asserted-by":"publisher","first-page":"e96911","DOI":"10.7759\/cureus.96911","volume":"17","author":"GS Reddy","year":"2025","unstructured":"Reddy GS, Reddy RA (2025) a prospective comparative study of preperitoneal vs. retro-rectus mesh placement in ventral hernia repair at a tertiary care hospital. Cureus 17(11):e96911. https:\/\/doi.org\/10.7759\/cureus.96911","journal-title":"Cureus"},{"issue":"4","key":"13217_CR24","doi-asserted-by":"publisher","first-page":"3061","DOI":"10.1007\/s00464-022-09475-5","volume":"37","author":"R Howard","year":"2023","unstructured":"Howard R, Ehlers A, Delaney L, Solano Q, Shen M, Englesbe M et al (2023) Sex disparities in the treatment and outcomes of ventral and incisional hernia repair. Surg Endosc 37(4):3061\u20133068. https:\/\/doi.org\/10.1007\/s00464-022-09475-5","journal-title":"Surg Endosc"}],"container-title":["Surgical Endoscopy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00464-026-13217-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00464-026-13217-2","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00464-026-13217-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T15:55:42Z","timestamp":1789142142000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00464-026-13217-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,11]]},"references-count":24,"alternative-id":["13217"],"URL":"https:\/\/doi.org\/10.1007\/s00464-026-13217-2","relation":{},"ISSN":["0930-2794","1432-2218"],"issn-type":[{"value":"0930-2794","type":"print"},{"value":"1432-2218","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,11]]},"assertion":[{"value":"28 March 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 July 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 September 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Collins, Aldridge, and Blackman have no conflicts of interest or financial ties to disclose.","order":1,"name":"Ethics","label":"Disclosures","group":{"name":"EthicsHeading","label":"Declarations"}}]}}