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.
journal_name
Surgeryjournal_title
Surgeryauthors
Loos MJ,Scheltinga MR,Roumen RMdoi
10.1016/j.surg.2009.08.008subject
Has Abstractpub_date
2010-02-01 00:00:00pages
275-81issue
2eissn
0039-6060issn
1532-7361pii
S0039-6060(09)00505-4journal_volume
147pub_type
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