Inguinal neurectomy for inguinal nerve entrapment: an experience with 100 patients
James A Madura1, James A Madura, Chad M Copper
1Division of General Surgery, The Indiana University Medical Center, 545 Barnhill Drive, EM Hall, Indianapolis, IN 46202, USA. jmadural@comcast.net
Background:
Inguinal nerve entrapment is a debilitating postoperative problem.
Patients And Methods:
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.
Results:
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.