Inguinodynia after two inguinal herniorrhaphy methods.
The aim of this study was to compare the rate and characteristics of postoperative neuralgia after 2 methods of inguinal hernia repairs. Between July 1997 and December 2000, 400 inguinal hernia repairs were performed and followed up in a prospective trial about postoperative nerve irritations: 200 patients with laparoscopic transabdominal hernioplasty (TAPP group), and 200 patients with tension-free hernia repair using Lichtenstein's technique (LICH group). We applied a clinic protocol of data about pain location, neuralgia characteristics, and period of time until the patient was completely pain free. The global rate of nerve irritation in the study was 7.6% (30 cases); in the TAPP group, it was 5.5% (n = 11) and in the LICH group, it was 9.5% (n = 19) (P = .03). The genitofemoral nerve was affected with particularly high frequency (4.3% in the global series); although in laparoscopic repair, the lateral cutaneous nerve of the thigh (LFC) was most damaged (3.3% in TAPP group). We observed more persistent symptoms in LICH group, while in TAPP group the most of cases was transitory (P = .08). There were no significant differences in pain characteristics according to clinical type of hernia. The TAPP method causes less rate of postoperative inguinal neuralgia than Lichtenstein repair, emphasizing more persistent discomfort in anterior approach than laparoscopic repair.
Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario "La Fe," Valencia. buenolledo@hotmail.com
Jose
J
Bueno
Alfonso
A
Serralta
Manuel
M
Planells
David
D
Rodero
D000328:Adult; D013505:Digestive System Surgical Procedures / Q000009:adverse effects*; D016099:Endoscopy, Gastrointestinal / Q000009:adverse effects; D006552:Hernia, Inguinal / Q000601:surgery*; D006801:Humans; D007264:Inguinal Canal / Q000294:innervation*; D007431:Intraoperative Complications / Q000209:etiology; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009408:Nerve Compression Syndromes / Q000209:etiology*; D009437:Neuralgia / Q000209:etiology*