Summary
Chronic pain on the ventral surface of the scrotum and the proximal ventro-medial surface of the thigh especially in athletes has been diagnosed in various ways; recently, in Europe the concept of “sports hernia” has been advocated. However, since few reports discuss the detailed course of the nerves in association with the pain, we examined the cutaneous branches in the inguinal region in 54 halves of 27 adult male cadavers. From our results, in addition to the cutaneous branches from the ilioinguinal n. (in 49 of 54: 90.7%), cutaneous branches originating from the genital branches of the genitofemoral nerve were found in the inguinal region in 19 of 54 halves (35.2%). In 7 cases (in 7 of 54: 13.0%) the genital branch and the ilioinguinal nerve united in the inguinal canal. In 6 cases the genital branch pierced the inguinal lig. to enter the inguinal canal, and in three cases the genital branch pierced the border between the ligament and the aponeurosis of the obliquus externus m. to be distributed to the inguinal region. Therefore, the courses of the genital branches vary considerably, and may have a very important role in chronic groin pain produced by groin hernia. In addition, entrapment by the ligament may be a reasonable candidate for the cause of chronic groin pain.
Résumé
La douleur chronique de la face ventrale du scrotum et de la face ventro-médiale proximale de la cuisse, en particulier chez les athlètes, a été interprétée de différentes manières ; le concept de “hernie du sport” a été récemment évoqué en Europe. Cependant, depuis que quelques rapports ont décrit le trajet détaillé des nerfs en association avec la douleur, nous avons examiné les branches cutanées de la région inguinale chez 27 cadavres mâles adultes (54 dissections). D'après nos résultats, dans la région inguinale, en plus des branches cutanées provenant du nerf ilio-inguinal (dans 49 des 54 cas ; 90,7 %) des branches cutanées provenant des branches génitales du nerf génito-fémoral ont été trouvées dans 19 des 54 dissections (35,2 %). Dans sept cas (7 des 54 cas, soit 13 %) la branche génitale et le nerf ilio-inguinal étaient unis ensemble dans le canal inguinal. Dans six cas, la branche génitale traversait le ligament inguinal pour entrer dans le canal inguinal, et dans trois cas la branche génitale traversait la frontière entre le ligament et l'aponévrose du muscle oblique externe pour se distribuer à la région inguinale. Ainsi, les trajets des branches génitales sont extrêmement variables, et peuvent avoir un rôle très important dans la douleur chronique de l'aine, attribuée habituellement à la hernie de l'aine. De plus, la contrainte mécanique liée au ligament peut être raisonnablement à l'origine de la douleur chronique de l'aine.
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Akita, K., Niga, S., Yamato, Y. et al. Anatomic basis of chronic groin pain with special reference to sports hernia. Surg Radiol Anat 21, 1–5 (1999). https://doi.org/10.1007/BF01635044
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DOI: https://doi.org/10.1007/BF01635044