title: Effectiveness of multiple neurectomies to prevent chronic groin pain after tension-free hernia repair.
abstract: The question of which nerve--the ilioinguinal or the iliohypogastric--most often causes chronic groin pain after hernia repair remains to be answered. We sought to evaluate the effects of prophylactic neurectomies on the incidence of persistent groin pain after Lichtenstein repair. Two hundred forty patients were randomized to 1 of 4 groups: the all-nerve preservation group, the ilioinguinal neurectomy group, the iliohypogastric neurectomy group, and the neurectomies group. During follow-up visits, pain was characterized through use of the McGill Pain Questionnaire and the visual analog scale, and quality of life was assessed with the Short Form 6 Dimension. Significant differences regarding chronic groin pain at 1 year were found between the preservation group and both neurectomies groups, in favor of the latter. No statistically significant differences in quality of life were noted in any of the groups. In conclusion, both nerves seem to be responsible for neuropathic postherniorrhaphy pain. Elective excision of the nerves can be done safely during tension-free hernia repair.
authors.affiliation: Faculty of Medicine, Department of General Surgery, Baskent University, Ankara, Turkey.
authors.forename: Feza
authors.initials: F
authors.lastname: Karakayali
authors.forename: Ergun
authors.initials: E
authors.lastname: Oksuz
authors.forename: Emin
authors.initials: E
authors.lastname: Turk
authors.forename: Mesut
authors.initials: M
authors.lastname: Pekmez
authors.forename: Zulfikar
authors.initials: Z
authors.lastname: Karabulut
authors.forename: Tugba
authors.initials: T
authors.lastname: Yilmaz
authors.forename: Gokhan
authors.initials: G
authors.lastname: Moray
authors.forename: Mehmet
authors.initials: M
authors.lastname: Haberal
mesh_terms: D000328:Adult; D000368:Aged; D002908:Chronic Disease; D006119:Groin / Q000294:innervation*; D006552:Hernia, Inguinal / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D009437:Neuralgia / Q000517:prevention & control / Q000601:surgery*; D010147:Pain Measurement; D010525:Peripheral Nerves / Q000601:surgery*; D011446:Prospective Studies; D011788:Quality of Life