Inguinal neurectomy for inguinal nerve entrapment: An experience with 100 patients

Inguinal nerve entrapment is a debilitating postoperative problem. One hundred patients were treated for inguinal nerve entrapment, including 52 men and 48 women with an average age of 45 ± 14 years. Most patients had inguinal hernia repairs or Pfannenstiel incisions. Mesh was found in 27% of patien...

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Bibliographic Details
Published in:The American journal of surgery 2005-03, Vol.189 (3), p.283-287
Main Authors: Madura, James A., Copper, Chad M., Worth, Robert M.
Format: Article
Language:English
Subjects:
Adult
Biological and medical sciences
Denervation
Female
General aspects
Genitofemoral nerves
Hernias
Humans
Inguinal Canal - innervation
Inguinal Canal - surgery
Inguinal nerves
Male
Medical research
Medical sciences
Middle Aged
Nerve Compression Syndromes - complications
Nerve Compression Syndromes - surgery
Neuralgia - etiology
Neuralgia - surgery
Neurectomy
Neuroma
Pain
Pain Measurement
Patients
Phenols
Postinguinal incision neuropathy
Postoperative Complications
Prostheses
Retrospective Studies
Standard deviation
Surgical Mesh
Treatment Outcome
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Summary:Inguinal nerve entrapment is a debilitating postoperative problem. One hundred patients were treated for inguinal nerve entrapment, including 52 men and 48 women with an average age of 45 ± 14 years. Most patients had inguinal hernia repairs or Pfannenstiel incisions. Mesh was found in 27% of patients. Symptoms included pain (100%), radiation of pain to the thigh and/or genital area (59%), and postural pain (59%). Diagnosis was made by physical examination, postural maneuvering, and inguinal nerve block. Proximal nerve resection was followed by Mersiline (Ethicon, Inc., Somerville, NJ) ligature and absolute alcohol or phenol application to prevent neuromas. Five percent of patients had minor complications. There was abnormal nerve histopathology in 18%. Total pain relief was attained in 72% of patients, partial relief in 25%, and no relief in 3%. Two patients complained of numbness postoperatively. Multifactorial analysis showed recurrent hernia repair as a significant predictive factor.
ISSN:0002-9610
1879-1883
DOI:10.1016/j.amjsurg.2004.11.015