A randomised controlled trial of injection therapy versus neurectomy for post-herniorrhaphy inguinal neuralgia: rationale and study design.
BACKGROUND
Chronic inguinal neuralgia is considered to be an important complication after hernia repair. As a high-level evidence-based treatment regime is currently lacking, these patients usually receive a random combination of pain medication, local nerve blocks or an occasional surgical neurectomy. A controlled trial ('GroinPain Trial') was constructed to identify the optimal treatment modality in this population. The aim and rationale of the trial are presented in this paper.


METHODS
Adult patients with chronic post-herniorrhaphy inguinal pain (>3 months) caused by inguinal nerve entrapment having a temporary pain reduction after a lidocain nerve block are eligible for randomisation. They received either repetitive nerve blocks with lidocain, corticosteroids and hyaluronic acid, or a 'tailored' surgical neurectomy.


RESULTS
Patient enrollment started in February 2006 and is expected to end in June 2010. The initial results will be available at the end of 2010.


CONCLUSIONS
This trial is the first randomised controlled effort comparing two invasive treatment modalities for peripheral inguinal nerve entrapment. As awareness and knowledge on chronic neuropathic pain after inguinal herniorrhaphy in the near future is expected to increase, the findings of this trial will aid in optimising care in this patient population.
Loos
M J A
MJ
Department of General Surgery, Máxima Medical Centre, P.O. Box 7777, De Run 4600, 5500 MB, Veldhoven, The Netherlands. loosmaarten@hotmail.com
Verhagen
T
T
Scheltinga
M R M
MR
Roumen
R M H
RM
D000328:Adult; D015340:Epidemiologic Research Design; D059685:Herniorrhaphy; D006801:Humans; D007267:Injections; D009408:Nerve Compression Syndromes / Q000209:etiology / Q000628:therapy*; D009437:Neuralgia / Q000209:etiology / Q000628:therapy*; D011183:Postoperative Complications