HerQLes is potentially a valuable tool to assess patient-centered abdominal wall functional improvements after HR. I prefer it.

QOL after hernia repair is measured by different ways.My preference is pain and normal functional activity.Of course if pain is present one cannot go back to normal function.

Dear Jensen

Zieren et al [1] studied the quality of life after elective hernia repair by using the Short-Form 36 questionnaire and found significant improvement in preoperative quality of life regarding freedom from pain, vitality, and physical

activity. Patients with scrotal hernia suffer preoperatively from an impaired quality of life, and it is unclear whether the quality of sexual lifeis improved by hernia repair.

The International Index of Erectile Function (IIEF) is a 15-item, self-administered questionnaire to assess male erectile function in the previous 4 weeks and is used to detect treatment-related changesIIEF was used to assess quality of sexual

function[2].

Ref

1 Zieren J, Kupper F, Paul M, Neuss H, Muller JM. Inguinal hernia:

obligatory indication for elective surgery? A prospective assessment

of quality of life before and after plug and patch inguinal hernia

repair. Langenbecks Arch Surg 2003;387:417–20.

2.Ertan T, Keskek M, Kilic M, Dizen H, Koc M, Tez M. Recovery of sexual function

after scrotal hernia repair. Am J Surg. 2007 ;194:299-303.