Testicular atrophy and chronic residual neuralgia as risks of inguinal hernioplasty.

Testicular atrophy can be prevented by limiting dissection trauma to the spermatic cord, specifically, leaving the distal part of the indirect inguinal hernia sacs in situ; never dissecting beyond the pubic tubercle; and using the properitoneal space when it is advisable, as in recurrent hernias, to avoid dissection of the spermatic cord altogether. Chronic residual neuralgia may be debilitating and difficult to manage. The involved nerve may be identified by local anesthetic nerve blocks. Neurectomy of the ilioinguinal, iliohypogastric, and genitofemoral nerves may cure the neuralgia.