Ilioinguinal Neurectomy and Chronic Post-Operative Pain after Inguinal Hernia Repair

Aliya Ishaq*, Shadab Khan, Mariya Ishaq, Muhammad Jamshaid Husain Khan and Ayesha Saba Khan

Department of General Surgery, Dubai Hospital, UAE

^*Correspondance to: Aliya Ishaq 

 PDF  Full Text DOI: 10.25107/2474-1647.3234

Abstract

Objective: This study aims to determine the effect of preservation/division of ilioinguinal nerve in patients undergoing lichenstein herniorrhaphy on severity of chronic post-operative pain as well as presence/absence of groin numbness. Method: A randomized control trial was conducted for a period of six months on 60 patient fulfilling inclusion criteria who underwent lichenstein herniorrhaphy at general surgery department of Liaquat National university hospital Karachi, Pakistan. Result: A total of 60 patients undergoing elective inguinal hernia mesh repair were. Included in study and divided in two groups with 30 patients each. Only male patients were included in the study as female gender was one of the exclusion criteria so gender stratification was no considered. Patients between 17 to 77 yrs of age were included in study and randomly divided in two groups. Mean age of population in group A is 42.96 ± 17.76 an in-group B is 54.23 ± 15.0. The minimum age of the patient in Group A is 17 years and maximum age is 73 years whereas minimum age of the patient in Group B is 20 years and maximum age is 77 years. 45.9% Patients in group A (Nerve preservation group) have right inguinal hernia. 54.0% Patients in group B (Nerve Division group) have right inguinal hernia. 56.5% Patients in group A (Nerve Preservation group) have left inguinal hernia. 43.4% Patients in group B (Nerve Division group) have left inguinal hernia. Chronic groin pain while different physical activities and groin numbness in nerve preservation and nerve division group was assessed at three and six months follow ups in all patients of the study population. 3% of the patients from nerve preservation group had mild pain during climbing stairs at three and six months follow up and the P-Value was 0.313 which is statistically not significant. 10% of the patients from nerve division group and 50% patients from nerve preservation group had pain during brisk walking at three months follow up and the P-Value was 0.001 which is statistically significant. 23% of the patients from nerve division group and 60% patients from nerve preservation group had pain during brisk walking at six months follow up and the P-Value was 0.004 which is statistically significant. 13.3% patients from nerve preservation group had moderate pain during brisk walking at three months follow up while none of the patient from nerve division group had pain and P-Value was 0.038 which is statistically significant. 6.6% of the patients from nerve preservation group had moderate pain during brisk walking at six months follow up while none of the patient from nerve division group had pain and P-Value was 0.150 which is statistically in significant. 20% of the patients from nerve division group and 30% of the patients from nerve preservation group had mild groin numbness at three months follow up with P-Value of 0.371 which is statistically in significant. 33.3% of the patients from nerve division group and 30% of the patients from nerve preservation group had groin numbness at six months follow up with a P-Value of 0.781 which is statistically in significant. Conclusion: Prophylactic ilioinguinal neurectomy during Lichtenstein tension free inguinal hernia repair decreases the incidence of exertional chronic post-operative pain as compare to the nerve preservation group. However, the cutaneous neurosensory disturbance/groin numbness between the two groups has no difference in term of outcome.

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Cite the article

Ishaq A, Khan S, Ishaq M, Jamshaid Husain Khan M, Saba Khan A. Ilioinguinal Neurectomy and Chronic Post-Operative Pain after Inguinal Hernia Repair. Clin Surg. 2021; 6: 3234..