Skip to main content
SpringerLink
Log in

Treatment for persistent chronic neuralgia after inguinal hernioplasty

  • Original Article
  • Published:
Hernia Aims and scope Submit manuscript

Abstract

Following an inguinal hernia repair with open or laparoscopic technique, 1–15% of patients show persistent neuralgia, a severe, potentially debilitating, complication. Several therapeutic procedures have been proposed, but consensus regarding choice of treatment has not yet been achieved. We performed a prospective study on 32 such cases. Patients underwent anaesthetic infiltration to identify, when possible, the involved nerve, and we then carried out a step-by-step therapeutic protocol. In the initial phase, patients were treated with oral analgesic and afterwards with repeated infiltrations of anaesthetic and cortisone. Surgery was reserved for patients not responding to the infiltrations, though with no good success. The authors believe that noninvasive methods are to be preferred, whereas neurectomy interventions should be reserved for selected cases.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Choi PD, Nath R, Mackinnon SE (1996) Iatrogenic injury to the ilioinguinal and iliohypogastric nerves in the groin: a case report, diagnosis and management. Ann Plast Surg 37:60–65

    Article  PubMed  CAS  Google Scholar 

  2. Heise CP, Starling JR (1998) Mesh inguinodynia: a new clinical syndrome after inguinal herniorrhaphy? J Am Coll Surg 187:514–518

    Article  PubMed  CAS  Google Scholar 

  3. Stark E, Oestreich K, Wendl K, Rumstad B, Hagmuller E (1999) Nerve irritation after laparoscopic hernia repair. Surg Endosc 3:878–881

    Article  Google Scholar 

  4. Kehlet H, Bay Nielsen M, Kingsnorth A (2002) Chronic postherniorrhaphy pain—a call for uniform assessment. Hernia 6:178–181

    Article  PubMed  CAS  Google Scholar 

  5. Bowen S, Moore BB, Weiss SM (1996) Neuralgia after inguinal hernia repair. Am Surg 62:664–667

    Google Scholar 

  6. Wantz GE (1993) Testicular atrophy and chronic residual neuralgia as risk of inguinal hernioplasty. Surg Clin North Am 73:571–581

    PubMed  CAS  Google Scholar 

  7. Amid PK (2004) Causes, prevention and surgical treatment of postherniorrhaphy neuropathic inguinodynia: triple neurectomy with proximal end implantation. Hernia 8:343–349

    Article  PubMed  CAS  Google Scholar 

  8. Kalan M, Chowdhry S (2004) Reducing the pain of open groin hernia repair. Hernia 8(4):381–383

    Article  PubMed  CAS  Google Scholar 

  9. Pokorny H, Klinger A, Scheyer M, Függer R, Bischof G (2006) Postoperative pain and quality of life after laparoscopic and open inguinal hernia repair: results of a perspective randomized trial. Hernia 10(4):331–337

    Article  PubMed  CAS  Google Scholar 

  10. Alfieri S, Rotondi F, Di Miceli D, Di Giorgio A, Pericoli Ridolfini M, Fumagalli U, Salzano A, Prete FP, Spadari A, Doglietto GB (2006) Chronic pain after inguinal hernia mesh repair: possible role of surgical manipulation of the inguinal nerves. A perspective multicentre study of 973 cases. Chir Ital 58:23–31

    PubMed  Google Scholar 

  11. Nirdlinger EL (2004) Causes of postoperative pain. Hernia 8(4):402

    Article  PubMed  Google Scholar 

  12. Krähenbühl L, Striffeler H, Baer HU, Büchler MW (1997) Retroperitoneal endoscopic neurectomy for nerve entrapment after hernia repair. Br J Surg 84:216–219

    Article  PubMed  Google Scholar 

  13. Gillion JF, Fagniez PL (1999) Chronic pain and cutaneous sensory changes after inguinal hernia repair: comparison between open and laparoscopic techniques. Hernia 3:75–80

    Article  Google Scholar 

  14. Callesen T, Karsten B, Andersen J, Nielsen R, Roikjaer O, Kehlet H (1999) Pain after primary inguinal herniorrhaphy: influence of surgical technique. J Am Coll Surg 188:355–359

    Article  PubMed  CAS  Google Scholar 

  15. Bay-Nielsen M, Perkins FM, Kehlet H (2001) Pain and functional impairment 1 year after inguinal herniorrhaphy. A nationwide questionnaire study. Ann Surg 233:1–7

    Article  PubMed  CAS  Google Scholar 

  16. Forte A, D’Urso A, Palumbo P, Lo Storto G, Gallinaro LS, Bezzi M, Beltrami V (2003) Inguinal hernioplasty: the gold standard of hernia repair. Hernia 7:35–38

    PubMed  CAS  Google Scholar 

  17. Nienhuijs SW, Boelens OBA, Strobbe LJA (2005) Pain after anterior mesh hernia repair. J Am Coll Surg 200:885–889

    Article  PubMed  Google Scholar 

  18. Sampath P, Yeo CJ, Campbell JN (1995) Nerve injury associated with laparoscopic inguinal herniorrhaphy. Surgery 118:829–833

    Article  PubMed  CAS  Google Scholar 

  19. Wulf H, Worthmann F, Behnke H, Böhle AS (1999) Pharmacokinetics and pharmacodynamics of Ropivacaine 2 mg/ml, 5 mg/ml or 7.5 mg/ml after ilioinguinal blockade for inguinal hernia repair in adults. Anesth Analg 89:1471–1474

    Article  PubMed  CAS  Google Scholar 

  20. Stoppa R (1997) Complications in hernia surgery. J Chir 134:158–168

    CAS  Google Scholar 

  21. Cunningham J, Temple WJ, Mitchell P, Nixon JA, Peshaw RM, Hagen NA (1996) Cooperative hernia study—pain in the postrepair patient. Ann Surg 224:598–602

    Article  PubMed  CAS  Google Scholar 

  22. Kennedy EM, Harms BA, Starling JR (1994) Absence of maladaptive neuronal plasticity after genitofemoral-ilioinguinal neurectomy. Surgery 116:665–671

    PubMed  CAS  Google Scholar 

  23. Pappalardo G, Guadalaxara A, Illomei G, d’Orta C, Frattaroli FM (1999) Prevention of postherniorrhaphy persistent pain: results of a prospective study. Int Surg 84:350–353

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Dipartimento di Chirurgia “Francesco Durante”, 1st Faculty of Medicine, Università degli Studi di Roma “La Sapienza”, Azienda Policlinico Umberto I, Viale del Policlinico 155, Rome, 00161, Italy

    P. Palumbo, A. Minicucci, A. G. Nasti, I. Simonelli, F. Vietri & A. M. Angelici

Authors
  1. P. Palumbo
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A. Minicucci
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. A. G. Nasti
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. I. Simonelli
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. F. Vietri
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. A. M. Angelici
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to P. Palumbo.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Palumbo, P., Minicucci, A., Nasti, A.G. et al. Treatment for persistent chronic neuralgia after inguinal hernioplasty. Hernia 11, 527–531 (2007). https://doi.org/10.1007/s10029-007-0268-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10029-007-0268-6

Keywords

Search

Navigation