Surgical management of 33 ilioinguinal and iliohypogastric neuralgias at Louisiana State University Health Sciences Center.

OBJECTIVE

This is a retrospective review of 33 charts of patients with ilioinguinal and iliohypogastric neuralgias who underwent a neurectomy at Louisiana State University Health Sciences Center between 1967 and 2000. Operations associated with neuralgias and postoperative pain outcomes were analyzed.

METHODS

There were 23 ilioinguinal and 10 combined ilioinguinal-iliohypogastric neuralgias, and the side of the lesion and sex of the patient were found to be evenly distributed in this group. Nerve blocks must have resulted in a complete or substantial decrease in pain before a neurectomy was recommended. Twenty-nine (88%) of 33 neuralgia patients had injuries from iatrogenic causes, and 4 (12%) injuries were caused by blunt trauma. In the 23 isolated ilioinguinal neuralgias, the operation associated with neuralgias in 13 (57%) of 23 patients was a herniorrhaphy. This was followed by 4 (17%) neuralgias after an appendectomy and 3 (13%) after a hysterectomy. Three (13%) patients had neuralgias resulting from blunt trauma. Nine (90%) of 10 ilioinguinal-iliohypogastric lesions were caused by iatrogenic causes, and 1 (10%) neuralgia resulted from blunt trauma. A neurectomy was performed in all patients.

RESULTS

The neurectomy resulted in considerable pain relief in 21 (91%) of 23 patients with ilioinguinal lesions and 9 (90%) of 10 patients with ilioinguinal-iliohypogastric lesions. Postoperative side effects were persistent numbness below the resected nerve and loss of the cremasteric reflex. Minor postoperative complications consisted of two superficial skin infections.

CONCLUSION

Ilioinguinal and ilioinguinal-iliohypogastric neuralgias are infrequent conditions; however, 33 patients from the Louisiana State University Health Sciences Center were accrued and analyzed in this study, and most had significant pain relief after neurectomy.