title: Genitofemoral and perineal neuralgia after transobturator midurethral sling.
abstract: BACKGROUND
  Midurethral slings successfully treat stress urinary incontinence through a minimally invasive vaginal approach. Postoperative pain related to sling placement can occur and poses both diagnostic and treatment dilemmas.
  
  
  METHODS
  Four years after transobturator midurethral sling placement, the patient presented with complaints of left labial pain and dyspareunia since surgery. Using sensory mapping and a nerve stimulator, the problem was identified in the distribution of the genitofemoral nerve. Conservative therapy with a centrally acting neuromodulatory drug and nerve block relieved the pain.
  
  
  CONCLUSIONS
  Postsling neuralgia diagnosis using sensory mapping and a nerve stimulator aids in indentifying the nerve involved and in successful conservative treatment with a nerve block.
authors.affiliation: From Department of Obstetrics and Gynecology, Divisions of Female Pelvic Medicine and Reconstructive Surgery and Advanced Laparoscopy and Pelvic Pain, the University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
authors.forename: Brent A
authors.initials: BA
authors.lastname: Parnell
authors.forename: Elisabeth A
authors.initials: EA
authors.lastname: Johnson
authors.forename: Denniz A
authors.initials: DA
authors.lastname: Zolnoun
mesh_terms: D000577:Amides; D018712:Analgesics, Non-Narcotic / Q000627:therapeutic use; D000779:Anesthetics, Local; D001340:Autonomic Nerve Block; D002220:Carbamazepine / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008012:Lidocaine; D035002:Lower Extremity / Q000294:innervation / Q000503:physiopathology; D008875:Middle Aged; D009437:Neuralgia / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D010149:Postoperative Pain / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D010502:Perineum / Q000294:innervation / Q000503:physiopathology; D000077212:Ropivacaine; D053825:Suburethral Slings / Q000009:adverse effects*; D014844:Vulva / Q000294:innervation* / Q000503:physiopathology
chemical_list: D000577:Amides; D018712:Analgesics, Non-Narcotic; D000779:Anesthetics, Local; D002220:Carbamazepine; D000077212:Ropivacaine; D008012:Lidocaine