Format

Send to

Choose Destination
See comment in PubMed Commons below
Surgery. 2010 Feb;147(2):275-81. doi: 10.1016/j.surg.2009.08.008. Epub 2009 Oct 13.

Tailored neurectomy for treatment of postherniorrhaphy inguinal neuralgia.

Author information

1
Department of General Surgery, Máxima Medical Center, Veldhoven, The Netherlands. loosmaarten@hotmail.com

Abstract

BACKGROUND:

Groin hernia repair occasionally leads to severe chronic pain associated with entrapped or damaged nerves. Conservative treatment is often unsuccessful. Selective neurectomy may be effective, but long-term results are scarce. The authors assessed the long-term efficacy of surgical neurectomy for chronic, postherniorrhaphy groin neuralgia.

METHODS:

A registry of patients with postherniorrhaphy groin pain treated by neurectomy was analyzed. Patients received a questionnaire evaluating the current pain intensity, overall treatment results, and effects on sexual intercourse-related pain. The risk factors for failure and presence of a learning curve were investigated.

RESULTS:

Fifty-four patients underwent a neurectomy over a 5-year time period, 49 of whom responded to the questionnaire (response rate, 91%). After a median follow-up period of 1.5 years, 52% claimed to be pain free or almost pain free (good to excellent), 24% reported some relief but still felt pain at a regular basis (moderate), and 24% did not benefit (poor or worse). Sexual intercourse-related pain responded favorably to neurectomy in two thirds of patients. There seemed to be a steep learning curve, and poor treatment results depended on previously received pain regimens (P = .021).

CONCLUSION:

A selective operative neurectomy for postherniorrhaphy groin neuralgia provides good long-term pain relief in most patients. Hernia surgeons should feel responsible for this iatrogenic complication and should consider incorporating selective neurectomy in their surgical armamentarium.

PMID:
19828170
DOI:
10.1016/j.surg.2009.08.008
[Indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments

    Supplemental Content

    Full text links

    Icon for Elsevier Science
    Loading ...
    Support Center