Patient-reported outcomes (PROs) after total extraperitoneal hernia repair (TEP)

E. H. H. Mommers*, D. R. M. Hunen, J. C. H. M. van Hout, M. Guit, J. A. Wegdam, S. W. Nienhuijs, T. S. de Vries Reilingh

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Background Patient-reported outcomes (PROs) such as quality of life (QoL), patient satisfaction, and work impairment, are arguably the most important outcomes of any medical treatment. In 2011, Staerkle and Villiger developed the Core Outcome Measurements Index (COMI) to standardise PROs and PRO measurement for inguinal hernia patients, in an attempt to increase inter-study comparability. The aim of this study is to prospectively evaluate the short-and long-term postoperative QoL, function, patient well-being, pain, and social/work disability, after total extraperitoneal (TEP) inguinal hernia repair and to provide the first clinical experience with the COMI-hernia questionnaire.

Methods Between January 2013 and December 2014, all patients >= 18 years that were scheduled for elective uni- or bilateral TEP in a regional hospital were approached to participate in this study. Measurements were taken preoperatively, and 6 weeks and 1 year postoperatively.

Results One hundred and twenty patients (113 men, 7 women), mean age 59 years (SD +/- 12), completed the follow-up of 1 year. Ninety-seven percent of the population reported that the operation improved their complaints. QoL, function, well-being, and pain all improved after 6 weeks and 1 year after surgery. Patients experienced more social and work-related limitations 6 weeks after surgery compared to baseline measurements, though this improved to normal 1 year postoperatively. The incidence of chronic pain was 14% (VAS >= 2), which had a negative impact on the patients' sense of well-being.

Conclusion Patients recovered well after TEP repair with a good quality of life and fast restore of function. Patient well-being was lower than expected due to a 14% incidence of chronic pain. The COMI-hernia scale provided reasonable insight into the patients' experience, though it was difficult to interpret for both patient and physician.

Original languageEnglish
Pages (from-to)45-50
Number of pages6
Issue number1
Publication statusPublished - Feb 2017


  • Total extraperitoneal herniorrhaphy (TEP)
  • Patient-reported outcome (PRO)
  • Quality of life (QoL)
  • Function
  • Patient well-being
  • Pain
  • Social and work disability
  • MESH

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