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Genitofemoral neuralgia

Nicholas Elkins, Jason Hunt, Kelly M Scott
Pelvic neuralgias frequently cause severe pain and may have associated bladder, bowel, or sexual dysfunctions which also impact quality of life. This article explores the etiology, epidemiology, presentation and treatment of common causes of neurogenic pelvic pain, including neuralgia of the border nerves (ilioinguinal, iliohypogastric, and genitofemoral), pudendal neuralgia, clunealgia, sacral radiculopathies caused by Tarlov cysts, and cauda equina syndrome. Treatment of pelvic neuralgia includes conservative measures such as pelvic physical therapy, lifestyle modification, and medications with escalation to more invasive and novel treatments such as nerve blocks, radiofrequency ablation, cryoablation, neuromodulation and neurectomy/neurolysis if conservative treatments are ineffective...
August 2017: Physical Medicine and Rehabilitation Clinics of North America
Bartosz Cybułka
With current technological advancement and availability of synthetic materials used in inguinal hernia repair, a recurrence after first intervention is not a common and important adverse event. On the other hand, however, some patients complain about chronic pain of the operated site after surgeries using a polypropylene mesh. Many patients are constrained to a prolonged use of analgesics and increased frequency of control visits, which may eventually result in loss of trust in the operator. Every surgical intervention is associated with the risk of immediate or delayed complications...
April 30, 2017: Polski Przeglad Chirurgiczny
Jan Fritz, A Lee Dellon, Eric H Williams, Gedge D Rosson, Allan J Belzberg, Frederick E Eckhauser
Purpose To determine if 3-T magnetic resonance (MR) neurography-guided retroperitoneal genitofemoral nerve (GFN) blocks are safe and effective for the diagnosis of genitofemoral neuralgia. Materials and Methods Following institutional review board approval and informed consent, 26 subjects (16 men, 10 women; mean age, 42 years [range, 24-78 years]; mean body mass index, 28 kg/m2 [range, 20-35 kg/m2 ]) with intractable groin pain were included. By using a 3-T MR imaging system, intermediate-weighted turbo spin-echo pulse sequences, and MR-conditional needles, diagnostic MR neurography-guided GFN blocks were performed in the retroperitoneum...
October 2017: Radiology
Vadim Petrov-Kondratov, Avneesh Chhabra, Stephanie Jones
Pudendal neuralgia (PN) is a result of pudendal nerve entrapment or injury, also called "Alcock syndrome." Pain that develops is often chronic, and at times debilitating. If conservative measures fail, invasive treatment modalities can be considered. The goal of this case report is to add to a small body of literature that a pulsed radiofrequency (PRF) ablation can be effectively used to treat PN and to show that high resolution MR neurography imaging can be used to detect pudendal neuropathy. CASE PRESENTATION: We present a case of a 51-year-old woman with 5 years of worsening right groin and vulva pain...
March 2017: Pain Physician
V Miccio, J Singh, J Bonder, R Navlani
No abstract text is available yet for this article.
April 2016: Journal of Pain: Official Journal of the American Pain Society
Vincent F Miccio, Rohit Navlani, Jaclyn H Bonder, Jaspal Ricky Singh
No abstract text is available yet for this article.
September 2016: Pain Physician
Andrew Shaw, Mayur Sharma, Zion Zibly, Daniel Ikeda, Milind Deogaonkar
OBJECTIVE: Ilioinguinal neuralgia (IG) and genitofemoral (GF) neuralgia following inguinal hernia repair is a chronic and debilitating neuropathic condition. Recently, peripheral nerve stimulation has become an effective and minimally invasive option for the treatment of refractory pain. Here we present a retrospective case series of six patients who underwent placement of peripheral nerve stimulation electrodes using various techniques for treatment of refractory post-intervention inguinal region pain...
December 2016: British Journal of Neurosurgery
D Ozkan, T Akkaya, S Yildiz, A Comert
Chronic pelvic pain is a condition that can be caused by pudendal neuralgia, interstitial cystitis, piriformis syndrome and neuropathy of the ilioinguinal, iliohypogastric and genitofemoral nerves. Based on three case reports this article discusses the clinical effectiveness of pulsed high-frequency radiofrequency (PRF) treatment applied to the pudendal nerve under ultrasound guidance in medicinally treated patients with chronic pelvic pain.
February 2016: Der Anaesthesist
Hans Verstraelen, Eline De Zutter, Martine De Muynck
The vulva is a particularly common locus of chronic pain with neuropathic characteristics that occurs in women of any age, though most women with neuropathic type chronic vulvar pain will remain undiagnosed even following multiple physician visits. Here, we report on an exemplary case of a middle-aged woman who was referred to the Vulvovaginal Disease Clinic with debilitating vulvar burning and itching over the right labium majus that had been persisting for 2 years and was considered intractable. Careful history taking and clinical examination, followed by electrophysiological assessment through somatosensory evoked potentials was consistent with genitofemoral neuralgia, for which no obvious cause could be identified...
2015: Journal of Pain Research
Alper Cesmebasi, Abhishek Yadav, Jerzy Gielecki, R Shane Tubbs, Marios Loukas
Genitofemoral neuralgia is a cause of neuropathic pain that is often debilitating in nature. It is characterized by chronic neuropathic groin pain that is localized along the distribution of the genitofemoral nerve. The symptoms include groin pain, paresthesias, and burning sensation spreading from the lower abdomen to the medial aspect of the thigh. It may present with scrotal pain in male, while females experience symptoms radiating to the labia majora and mons pubis. Genitofemoral neuropathy has been attributed to iatrogenic nerve injury occurring during inguinal and femoral herniorrhaphy, with cases developing after both open and laparoscopic techniques...
January 2015: Clinical Anatomy
Harsha Shanthanna
A young male patient developed chronic, severe, and disabling right sided groin pain following resection of his left testicular cancer. Since there is considerable overlap, ultrasound guided, selective diagnostic nerve blocks were done for ilioinguinal, iliohypogastric, and genitofemoral nerves, to determine the involved nerve territory. It was revealed that genitofemoral neuralgia was the likely cause. As a therapeutic procedure, it was injected with local anesthetic and steroid using ultrasound guidance. The initial injection led to pain relief of 3 months...
2014: Case Reports in Anesthesiology
Feridun Acar, Mevci Ozdemir, Fatih Bayrakli, Bayram Cirak, Erdal Coskun, Kim Burchiel
AIM: To evaluate the effectiveness of invasive procedures in medically intractable genitofemoral and ilioingunal neuralgia. MATERIAL AND METHODS: This is a prospective study of 20 patients with genitofemoral and ilioinguinal neuralgias who were treated at our medical center between 2007 and 2011. Genitofemoral and ilioinguinal nerve blocks were performed in all cases after medical treatment had failed to alleviate the patients' pain. Neurectomy was performed for the patients whose pain did not improve...
2013: Turkish Neurosurgery
David C Chen, Jonathan R Hiatt, Parviz K Amid
IMPORTANCE: With the technical success of tension-free inguinal herniorrhaphy, chronic groin pain has far surpassed recurrence as the most common long-term complication. OBJECTIVE: To evaluate laparoscopic triple neurectomy of the ilioinguinal, iliohypogastric, and genitofemoral nerve trunks in the retroperitoneal lumbar plexus for treatment of refractory inguinodynia. DESIGN: Prospective study. SETTING: University hernia center...
October 2013: JAMA Surgery
J M Bischoff, E K Aasvang, H Kehlet, M U Werner
PURPOSE: Nerve identification during open inguinal hernia herniorrhaphy has been suggested as one of the factors that may reduce the risk of development of persistent postherniorrhaphy pain. In this prospective study, we evaluated whether intraoperative inguinal nerve identification influenced the risk of development of persistent postherniorrhaphy pain, sensory dysfunction in the groin and functional ability score after open hernia repair. METHODS: A total of 244 men with a primary inguinal hernia underwent open Lichtenstein repair in a high-volume hernia surgery centre, where information on inguinal nerve identification was registered during operation...
October 2012: Hernia: the Journal of Hernias and Abdominal Wall Surgery
Brent A Parnell, Elisabeth A Johnson, Denniz A Zolnoun
BACKGROUND: Midurethral slings successfully treat stress urinary incontinence through a minimally invasive vaginal approach. Postoperative pain related to sling placement can occur and poses both diagnostic and treatment dilemmas. CASE: Four years after transobturator midurethral sling placement, the patient presented with complaints of left labial pain and dyspareunia since surgery. Using sensory mapping and a nerve stimulator, the problem was identified in the distribution of the genitofemoral nerve...
February 2012: Obstetrics and Gynecology
Lukas Brügger, Martina Bloesch, Ramin Ipaktchi, Anita Kurmann, Daniel Candinas, Guido Beldi
BACKGROUND: Irritation of inguinal nerves with laparoscopic hernia repair may cause chronic neuralgia and hypoesthesia. Hypoesthesia in particular is generally not assessed objectively. We objectively investigated hypoesthesia and chronic pain after transabdominal preperitoneal inguinal hernia repair (TAPP) with titanium spiral tacks (STs) compared with tissue adhesive (TA) for mesh fixation. METHODS: Mesh fixation in 80 TAPP procedures was randomized to fixation with ST (n = 40) or TA (n = 40)...
April 2012: Surgical Endoscopy
J-J Labat, R Robert, D Delavierre, L Sibert, J Rigaud
OBJECTIVES: To determine the characteristics of neuropathic pain and the somatic nerve lesions most frequently encountered in the context of chronic pelvic and perineal pain. MATERIAL AND METHODS: Review of the literature devoted to pelvic and perineal neuralgia. RESULTS: The diagnosis of pelvic and perineal pain related to a somatic nerve lesion is essentially clinical. The topography of the pain and its characteristics (burning, paraesthesia, etc...
November 2010: Progrès en Urologie
David Parris, Nancy Fischbein, Sean Mackey, Ian Carroll
BACKGROUND: Inguinal hernia repair is associated with a high incidence of chronic postsurgical pain. This pain may be caused by injury to the iliohypogastric, ilioinguinal, or genitofemoral nerves. It is often difficult to identify the specific source of the pain, in part, because these nerves are derived from overlapping nerve roots and closely colocalize in the area of surgery. It is therefore technically difficult to selectively block these nerves individually proximal to the site of surgical injury...
May 2010: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Andrew C Zacest, Stephen T Magill, Valerie C Anderson, Kim J Burchiel
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...
April 2010: Journal of Neurosurgery
U Giger, M N Wente, M W Büchler, S Krähenbühl, J Lerut, L Krähenbühl
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...
September 2009: British Journal of Surgery
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