Chronic Groin Pain After Hernia Surgery: What Are We Missing?

Background: Chronic postoperative inguinal pain [CPIP] is a prevalent and often debili-tating complication following inguinal hernia repair. With the widespread adoption of mesh-based techniques, recurrence rates have declined, shifting clinical focus toward postoperative pain management. Methods: This narrative review synthesizes international literature on CPIP incidence, surgical technique, geographic variation, and the distinction between neuropathic and nociceptive pain. Studies were selected according to relevance, sample size, and inclusion of pain subclassification. Results: CPIP incidence varies widely across studies (6%–64.3%), as it is influenced by follow-up duration, surgical approach, and regional healthcare practices. Laparoscopic techniques generally yield lower CPIP rates, though exceptions exist. Neuropathic pain predominates in certain cohorts, particularly following open repairs with limited nerve preservation. Few studies differentiate pain types, revealing a gap in diagnostic rigor. Conclusions: CPIP is a multifactorial and underrecognized problem in clinical practice. Standardized diagnostic tools and long-term follow-up are essential to improve classifica-tion and management. A structured algorithm may aid clinicians in distinguishing pain types and tailoring treatment strategies.