We aim to draw attention to a meaningful public health concern regarding chronic pain after inguinal hernia repair, emphasizing the need for thoughtful, evidence‑based, and patient‑focused management. Despite its frequency (27% of men), this procedure, often perceived as benign, can lead to disabling pain (0.5–6% of cases) and daily handicap, which is underestimated by official registries.

Our hypothesis was drawn from the French figures, over 200,000 surgeries are performed annually, yet fewer than 30 serious adverse events per year were reported between 2020 and 2024. We used a minimum rate of complication at 0.5%. We performed a Monte Carlo simulation based on a beta–binomial distribution to describe the credibility interval of an estimate grounded in real‑world surgical practice expecting 1066 (CI95%: 604–1650) complications.

Our article highlights the discrepancy between clinical data, registry data, and the reality experienced by patients with chronic postoperative pain—pain that is often undertreated, overlooked, or misunderstood — and who still tend to be attributed psychological causes (such as anxiety or depression) rather than organic factors (such as BMI or hernia size). Surgical techniques, with or without prostheses, and approaches (open, laparoscopic) vary, but their long-term evaluation lacks data. Medico-economic costs and disparities in access to care (rich countries vs. low-income countries) exacerbate inequalities.

Chronic pain requires multidisciplinary management (medications, neurectomies, neuromodulation, psychology), but care pathways remain fragmented and siloed. Health authorities have acknowledged the urgency, yet scientific societies struggle to integrate patients' experiential knowledge and effective monitoring of medical devices. Although outpatient surgery is efficient and widely adopted, its streamlined nature may make complications less visible.

In light of this body of evidence, we call for an independent and truly systemic approach—one that integrates robust epidemiological registries, transparent evaluation of medical devices through national health data infrastructures, and meaningful patient involvement in decision‑making. Public health must move beyond disciplinary silos to foster care that is both more humane and more equitable.