Ilioinguinal nerve entrapment

INTRODUCTION: Chronic pelvic and perineal pain can be related to a nerve lesion caused by direct or indirect trauma or by an entrapment syndrome, which must then be demonstrated by a test block. The purpose of this article is to review the techniques and modalities of somatic nerve block in the management of chronic pelvic and perineal pain. MATERIAL AND METHODS: A review of the literature was performed by searching PubMed for articles on somatic nerve infiltrations in the management of chronic pelvic and perineal pain...

OBJECTIVE: Nerves of the pelvic plexus and lower abdominal wall can lead to chronic neuralgias owing to a variety of causes, including iatrogenic injury, trauma, tumors, and primary nerve entrapment. Differentiating among the various neural etiologies can be a challenging task. Here, we present a large series of patients who underwent surgical treatment of these nerves, with an emphasis on diagnostic and therapeutic considerations. METHODS: Between 1970 and 2006, the senior authors (DGK and DHK) surgically treated 264 cases of neuralgia of the pelvic plexus and nerves...

OBJECT: Ilioinguinal neuralgia is one cause of chronic groin pain following inguinal hernia repair, and it affects approximately 10% of patients. Selective ilioinguinal neurectomy is one proposed treatment option for carefully selected patients. The goal of this study was to determine the long-term outcome of patients who underwent selective ilioinguinal neurectomy for chronic post-hernia pain. METHODS: The authors retrospectively reviewed the clinical assessment, surgical treatment, and long-term outcome in 26 patients with ilioinguinal neuralgia who underwent selective ilioinguinal neurectomy performed by the senior author (K...

BACKGROUND: Chronic postoperative pain after inguinal surgery remains a difficult problem. The role of minimally invasive surgery in this complex setting is still unexplored. METHODS: Between January 1997 and January 2007, 34 men and five women with a mean(s.d.) age of 47(16) years underwent endoscopic retroperitoneal neurectomy (ERN) for chronic neuropathic groin pain due to genitofemoral nerve with or without ilioinguinal nerve entrapment. Follow-up data were obtained 1 and 12 months after surgery...

BACKGROUND: Chronic neuropathy after hernia repair is a neglected problem as very few patients are referred for surgical treatment. The aim of the present study was to assess the outcome of standardized surgical revision for neuropathic pain after hernia repair. METHODS: In a prospective cohort study we evaluated all patients admitted to our tertiary referral center for surgical treatment of persistent neuropathic pain after primary herniorrhaphy between 2001 and 2006...

Sciatic nerve injury associated with acetabular fractures has been reported in most series. Typically, sciatic neuropraxia occurs from traumatic impaction or compression due to posterior hip fracture-dislocation. We report 2 patients with sciatic nerve entrapment within the posterior column components of their associated both-column acetabular fractures. Following neuroplasty through a Kocher-Langenbeck surgical approach, both patients' neurologic function improved. This unlikely cause of neurologic compromise should be considered in all patients with symptoms of sciatic nerve injury or irritation and particularly in the presence of a mechanical block during posterior column reduction through an ilioinguinal approach...

OBJECTIVE: The authors assessed the long-term pain relief after local nerve blocks or neurectomy in patients suffering from chronic pain because of Pfannenstiel-induced nerve entrapment. SUMMARY BACKGROUND DATA: The low transverse Pfannenstiel incision has been associated with chronic lower abdominal pain because of nerve entrapment (2%-4%). Treatment options include peripheral nerve blocks or a neurectomy of neighboring nerves. Knowledge on adequate (surgical) management is scarce...

OBJECTIVES: Mild pain lasting for a few days is common following mesh inguinal hernia repair. In some patients however, severe groin pain may appear months or even years postoperatively. The aim of this study was to report our experience of late-onset persisting severe postoperative groin pain occurring years after mesh hernioplasty. METHODS: In a 9-year period, 1,633 patients (1,073 men), median age 63 years (range 19-88), underwent mesh groin hernia repair. Between 1...

Ilioinguinal neuropathy is a well-described complication of mesh inguinal herniorrhaphy. We report the first human case, to our knowledge, of ilioinguinal nerve mesh entrapment with neuropathological changes that suggest an inflammatory cause for this chronic pain syndrome.

UNLABELLED: Chronic pain in the hip, groin or thigh can be caused by a wide spectrum of diseases posing extended diagnostic problems. We describe the case of a 10-years old child with chronic pain in the groin with gait restriction for more than six months without successful classification and treatment. The girl suffered from heavy pain in the groin after a sporting contest which forced her to walk with walking sticks and to avoid climbing stairs. Within six months she was examined by pediatric, orthopedic, pediatric surgery, pediatric orthopedic, radiology, pediatric rheumatology specialists...

BACKGROUND: Tension-free inguinal hernia repair is one of the so-called painless operations. Mild or medium postoperative pain, however, even in the mesh repair era, is common and usually due to ilioinguinal nerve entrapment or mesh fixation in the periostium of the pubic tubercle. Especially in indirect inguinal hernia repair, however, hernia sac ligation and excision may be the cause of pain. The aim of this study was to conduct a single-center prospective randomized trial with a view to clarify this issue on a scientific basis...

Ilioinguinal nerve entrapment presents with a clinical triad of pain in the iliac fossa and inguinal region, sensory abnormalities in the cutaneous distribution of the nerve and tenderness on palpation 2-3 cm medial and below the anterior superior iliac spine. The syndrome poses diagnostic difficulties, as genitofemoral nerve entrapment and non-neurological conditions of the lower abdomen may cause similar pain. We report on a patient with acute groin pain radiating towards the scrotum, caused by ilioinguinal nerve entrapment...

BACKGROUND: There are numerous possible causes for chronic pelvic pain. Evaluation of these causes should begin with the least invasive form of assessment. CASE: A 28-year-old woman with chronic pelvic pain underwent an array of investigations and surgical interventions without relief of pain. When she was admitted to hospital because of a flare up of pelvic pain, the chronic pain service was consulted. The presentation of stabbing pain that was reproduced by eliciting focal tenderness over the course of ilioinguinal nerve made nerve entrapment a possible diagnosis...

BACKGROUND AND PURPOSE: Ilioinguinal neuralgia secondary to inguinal hernia repair is frequently a chronic, debilitating pain. It is most often due to destruction or entrapment of nerve tissue from staples, sutures, or direct surgical trauma. Treatment modalities, including oral analgesics, nerve blocks, mesh excision, and surgical neurectomy, have varied success rates. Pulsed radiofrequency (PRF) has recently been described as a successful method of treating chronic groin pain. Unlike conventional radiofrequency, PRF is non-neurodestructive and therefore less painful and without the potential complications of neuritis-like reactions and neuroma formation...

BACKGROUND: Ilioinguinal nerve entrapment is one of the most common nerve injuries following pelvic surgery. We present a case of intractable right lower quadrant pain successfully treated with neurectomy. CASE: A 31-year-old woman, following her third elective cesarean section, noted intense, right inguinal pain immediately upon awaking from anesthesia. The pain was burning and constant and exacerbated by standing and movement. After a period of failed conservative management, a workup concluded probable nerve entrapment...

OBJECTIVES: Repair of groin hernia is one of the most common operations performed by general surgeons, and mesh repair methods have gained wide acceptance. Chronic pain is the most serious long-term complication that can occur after repair of groin hernia. The development of chronic pain after herniorraphy has been attributed to several mechanisms, including damage to sensory nerves and mesh inguinodynia. MATERIAL AND METHODS: Twenty-four rabbits underwent bilateral inguinal dissection and synthetic polypropylene mesh laid on one side...

A number of unusual conditions was diagnosed in 6 patients with inguinal pain. A 30-year-old man had iliopectineal bursitis on the right as well as a recurrent left inguinal hernia; many years after a Pfannenstiel incision a woman aged 57 harboured an entrapment of the ilioinguinal nerve; a 26-year-old woman suffered from endometriosis in the round ligament; a man aged 65 had compression of the genitofemoral nerve caused by a left iliac aneurysm; a woman aged 38 demonstrated symptoms of an anterior snapping hip; and a man aged 42 had retroperitoneal compression of nerves caused by a sarcoma...

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OBJECTIVE: To estimate the incidence, etiology, and outcome of neuropathies after major gynecologic surgery and to recommend management and prevention strategies for these complications. METHODS: The medical records of women who suffered neuropathy after major pelvic surgery between July 1995 and June 2001 were reviewed. Mechanism of injury, treatment, and outcome were determined from the patient charts. RESULTS: Twenty-three of 1210 patients undergoing major pelvic surgery during the defined period suffered a postoperative neuropathy for an incidence of 1...

The anatomy of the ilioinguinal nerve makes it vulnerable to entrapment near its exit from the superficial inguinal ring, where it lies almost directly superior to the pubic tubercle. Ilioinguinal nerve entrapment is a documented complication of inguinal herniorrhaphy, inguinal lymph node dissection, appendectomy, Pfannenstiel incision and the needle suspension procedure. It has not previously been described as a complication of the tension-free vaginal tape (TVT) procedure, which is the most recent technique for the treatment of genuine urinary stress incontinence...