Mesh Removal Versus No Mesh Removal for Chronic Groin Pain After Inguinal Hernia Repair

Inclusion Criteria: * \> 18 years of age * CPIP lasting \> 6 months after laparoscopic or robotic inguinal hernia repair with pre-peritoneal mesh * Must exhibit 1 or more of the following characteristics of nociceptive pain: History: * Pain while sitting in a chair for prolonged periods of time with relief when extending the hip or lying supine to straighten the leg * Severe pain when crossing the affected leg over the contralateral leg * "Foreign body sensation" or "tightness" in the groin Exam: -Diffuse tenderness with deep palpation along the inguinal ligament (over the mesh) Somatosensory mapping: * Does not have a maximum trigger point for pain * Lacks characteristics of neuropathic pain (sharp, burning, shooting, paresthesias, allodynia, hyperalgesia, etc.) * Moderate to severe pain \[4-10\] when moving from supine to standing on NRS Exclusion Criteria: * No characteristics of nociceptive groin pain * Zero or mild pain \[0-3\] when moving from supine to standing on NRS * Recurrent inguinal hernia detected on clinical exam * Large, femoral, direct or indirect inguinal hernia (F2-3, M2-3, L2-3) on diagnostic laparoscopy as defined by European Hernia Society (EHS) classification * Prior open (anterior) approach to inguinal hernia repair (i.e. Lichtenstein) * Prior mesh plugs or Prolene Hernia Systems * History of prostatectomy or vascular procedures in the pelvis or groin