title: Algorithm for treatment of postoperative incisional groin pain after cesarean delivery or hysterectomy.
abstract: OBJECTIVE
  Despite the low mortality and morbidity of major obstetric and gynecologic surgeries (including hysterectomy and cesarean delivery), women undergoing these procedures occasionally suffer from intractable postoperative suprapubic and groin pain. We present seven patients whose intractable pain lasted longer than 6 months and was not due to gynecologic disease or other obvious pathology.
  
  
  METHODS
  Neuromas of the ilioinguinal, iliohypogastric, and/or genitofemoral nerves were suspected clinically and confirmed intraoperatively.
  
  
  RESULTS
  After neuroma resection, all patients reported complete and durable pain relief.
  
  
  CONCLUSIONS
  Intractable pain after obstetric or gynecologic surgery can be due to neuroma formation, and resection is therapeutic. We suggest an algorithm for the management of women with chronic intractable suprapubic or groin pain after major obstetric and gynecologic surgery.
  
  
  METHODS
  II-3.
authors.affiliation: Department of Plastic Surgery, Georgetown University Hospital, Washington, DC 20007, USA. ducici@gunet.georgetown.edu
authors.forename: Ivica
authors.initials: I
authors.lastname: Ducic
authors.forename: Michael
authors.initials: M
authors.lastname: Moxley
authors.forename: Ali
authors.initials: A
authors.lastname: Al-Attar
mesh_terms: D000465:Algorithms; D002585:Cesarean Section; D005260:Female; D006119:Groin / Q000294:innervation; D006801:Humans; D007044:Hysterectomy; D009463:Neuroma / Q000175:diagnosis / Q000601:surgery*; D010149:Postoperative Pain / Q000209:etiology / Q000601:surgery*; D010524:Peripheral Nervous System Neoplasms / Q000175:diagnosis / Q000601:surgery*; D011183:Postoperative Complications / Q000601:surgery; D011247:Pregnancy