Advertisement

Ilioinguinal Nerve Entrapment: Pelvic

  • Natalia MurinovaEmail author
  • Daniel Krashin
  • Andrea M. Trescot

Abstract

Ilioinguinal nerve entrapment is a common cause of groin or inguinal area pain. The ilioinguinal nerve can become entrapped after pelvic or hernia surgery, which can result in disabling pain in the inguinal area, lateral genitalia, or abdominal wall. The distribution and features of this pain can vary between patients, depending on anatomic variations in the course of the ilioinguinal nerve and the location of the entrapment. The pain can be diagnosed with nerve blocks and treated with neurolysis or neurectomy. Ilioinguinal entrapment causing abdominal pain is discussed in Chap. 40; this chapter discusses ilioinguinal entrapment causing groin and pelvic pain.

Keywords

Ilioinguinal nerve Ilioinguinal nerve entrapment Groin pain Post-hernia pain Pelvic pain Inguinodynia 

Supplementary material

Video 44.1

Physical exam of the ilioinguinal nerve (MOV 69110 kb)

Video 44.2

Landmark-guided injection of the ilioinguinal nerve (MOV 58145 kb)

References

  1. 1.
    Bardeen CR. A statistical study of the abdominal and border nerves in man. Am J Anat. 1902;1(1):203–28.CrossRefGoogle Scholar
  2. 2.
    Peng P, Tumber PS. Ultrasound-guided interventional procedures for patients with chronic pelvic pain – a description of techniques and review of literature. Pain Physician. 2007;11(2):215–24.Google Scholar
  3. 3.
    Ndiaye A, Diop M, Ndoye JM, Konate I, Ndiaye AI, Mane L, et al. Anatomical basis of neuropathies and damage to the ilioinguinal nerve during repairs of groin hernias. (about 100 dissections). Surg Radiol Anat. 2007;29(8):675–81.CrossRefPubMedGoogle Scholar
  4. 4.
    Stulz P, Pfeiffer KM. Peripheral nerve injuries resulting from common surgical procedures in the lower portion of the abdomen. Arch Surg. 1982;117(3):324–7.CrossRefPubMedGoogle Scholar
  5. 5.
    Whiteside JL, Barber MD, Walters MD, Falcone T. Anatomy of ilioinguinal and iliohypogastric nerves in relation to trocar placement and low transverse incisions. Am J Obstet Gynecol. 2003;189(6):1574–8.CrossRefPubMedGoogle Scholar
  6. 6.
    Kim DH, Murovic JA, Tiel RL, Kline DG. Surgical management of 33 ilioinguinal and iliohypogastric neuralgias at Louisiana State University Health Sciences Center. Neurosurgery. 2005;56(5):1013–20; discussion – 20.PubMedGoogle Scholar
  7. 7.
    Starling JR, Harms BA, Schroeder ME, Eichman PL. Diagnosis and treatment of genitofemoral and ilioinguinal entrapment neuralgia. Surgery. 1987;102(4):581–6.PubMedGoogle Scholar
  8. 8.
    Hollis MH, Lemay DE. Nerve entrapment syndromes of the lower extremity: Medscape; 2012. Available from: http://emedicine.medscape.com/article/1234809-overview.
  9. 9.
    Toussaint CP, Perry 3rd EC, Pisansky MT, Anderson DE. What’s new in the diagnosis and treatment of peripheral nerve entrapment neuropathies. Neurol Clin. 2010;28(4):979–1004.CrossRefPubMedGoogle Scholar
  10. 10.
    Hahn L. Clinical findings and results of operative treatment in ilioinguinal nerve entrapment syndrome. BJOG Int J Obstet Gynaecol. 1989;96(9):1080–3.CrossRefGoogle Scholar
  11. 11.
    Benes J, Nádvornik P, Dolezel J. Abdominoinguinal pain syndrome treated by centrocentral anastomosis. Acta Neurochir (Wien). 2000;142(8):887–91.CrossRefGoogle Scholar
  12. 12.
    Soneji N, Peng PW. Ultrasound-guided pain interventions – a review of techniques for peripheral nerves. Korean J Pain. 2013;26(2):111–24.CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Rab M, Ebmer, Dellon AL. Anatomic variability of the ilioinguinal and genitofemoral nerve: implications for the treatment of groin pain. Plast Reconstr Surg. 2001;108(6):1618–23.CrossRefPubMedGoogle Scholar
  14. 14.
    Poobalan AS, Bruce J, Smith WC, King PM, Krukowski ZH, Chambers WA. A review of chronic pain after inguinal herniorrhaphy. Clin J Pain. 2003;19(1):48–54.CrossRefPubMedGoogle Scholar
  15. 15.
    Giger U, Wente M, Büchler M, Krähenbühl S, Lerut J, Krähenbühl L. Endoscopic retroperitoneal neurectomy for chronic pain after groin surgery. Br J Surg. 2009;96(9):1076–81.CrossRefPubMedGoogle Scholar
  16. 16.
    Luijendijk RW, Jeekel J, Storm RK, Schutte PJ, Hop W, Drogendijk AC, et al. The low transverse Pfannenstiel incision and the prevalence of incisional hernia and nerve entrapment. Ann Surg. 1997;225(4):365.CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    Douek M, Smith G, Oshowo A, Stoker D, Wellwood J. Prospective randomised controlled trial of laparoscopic versus open inguinal hernia mesh repair: five year follow up. BMJ. 2003;326(7397):1012–3.CrossRefPubMedPubMedCentralGoogle Scholar
  18. 18.
    Bringman S, Ramel S, Heikkinen T-J, Englund T, Westman B, Anderberg B. Tension-free inguinal hernia repair: TEP versus mesh-plug versus Lichtenstein: a prospective randomized controlled trial. Ann Surg. 2003;237(1):142.CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    Nordin P, Bartelmess P, Jansson C, Svensson C, Edlund G. Randomized trial of Lichtenstein versus Shouldice hernia repair in general surgical practice. Br J Surg. 2002;89(1):45–9.CrossRefPubMedGoogle Scholar
  20. 20.
    Vrijland W, van Den Tol M, Luijendijk R, Hop W, Busschbach J, de Lange D, et al. Randomized clinical trial of non‐mesh versus mesh repair of primary inguinal hernia. Br J Surg. 2002;89(3):293–7.CrossRefPubMedGoogle Scholar
  21. 21.
    Eichenberger U, Greher M, Kirchmair L, Curatolo M, Moriggl B. Ultrasound-guided blocks of the ilioinguinal and iliohypogastric nerve: accuracy of a selective new technique confirmed by anatomical dissection. Br J Anaesth. 2006;97(2):238–43.CrossRefPubMedGoogle Scholar
  22. 22.
    Bischoff JM, Koscielniak-Nielsen ZJ, Kehlet H, Werner MU. Ultrasound-guided ilioinguinal/iliohypogastric nerve blocks for persistent inguinal postherniorrhaphy pain: a randomized, double-blind, placebo-controlled, crossover trial. Anesth Analg. 2012;114(6):1323–9.CrossRefPubMedGoogle Scholar
  23. 23.
    Kehlet H, Jensen TS, Woolf CJ. Persistent postsurgical pain: risk factors and prevention. Lancet. 2006;367(9522):1618–25.CrossRefPubMedGoogle Scholar
  24. 24.
    Fanelli RD, DiSiena MR, Lui FY, Gersin KS. Cryoanalgesic ablation for the treatment of chronic postherniorrhaphy neuropathic pain. Surg Endosc. 2003;17(2):196–200.CrossRefPubMedGoogle Scholar
  25. 25.
    Hakeem A, Shanmugam V. Current trends in the diagnosis and management of post-herniorraphy chronic groin pain. World J Gastrointest Surg. 2011;3(6):73–81.CrossRefPubMedPubMedCentralGoogle Scholar
  26. 26.
    Kastler A, Aubry S, Piccand V, Hadjidekov G, Tiberghien F, Kastler B. Radiofrequency neurolysis versus local nerve infiltration in 42 patients with refractory chronic inguinal neuralgia. Pain Physician. 2012;15(3):237–44.PubMedGoogle Scholar
  27. 27.
    Mitra R, Zeighami A, Mackey S. Pulsed radiofrequency for the treatment of chronic ilioinguinal neuropathy. Hernia. 2007;11(4):369–71.CrossRefPubMedPubMedCentralGoogle Scholar
  28. 28.
    Rozen D, Ahn J. Pulsed radiofrequency for the treatment of ilioinguinal neuralgia after inguinal herniorrhaphy. Mt Sinai J Med N Y. 2006;73(4):716–8.Google Scholar
  29. 29.
    Rozen D, Parvez U. Pulsed radiofrequency of lumbar nerve roots for treatment of chronic inguinal herniorraphy pain. Pain Physician. 2006;9(2):153–6.PubMedGoogle Scholar
  30. 30.
    Makharita MY, Amr YM. Pulsed radiofrequency for chronic inguinal neuralgia. Pain Physician. 2015;18(2):E147–55.PubMedGoogle Scholar
  31. 31.
    Rosendal F, Moir L, de Pennington N, Green AL, Aziz TZ. Successful treatment of testicular pain with peripheral nerve stimulation of the cutaneous branch of the ilioinguinal and genital branch of the genitofemoral nerves. Neuromodulation. 2013;16(2):121–4.CrossRefPubMedGoogle Scholar
  32. 32.
    Banh DP, Moujan PM, Haque Q, Han TH. Permanent implantation of peripheral nerve stimulator for combat injury-related ilioinguinal neuralgia. Pain Physician. 2013;16(6):E789–91.PubMedGoogle Scholar
  33. 33.
    Elahi F, Reddy C, Ho D. Ultrasound guided peripheral nerve stimulation implant for management of intractable pain after inguinal herniorrhaphy. Pain Physician. 2015;18(1):E31–8.PubMedGoogle Scholar
  34. 34.
    Zacest AC, Magill ST, Anderson VC, Burchiel KJ. Long-term outcome following ilioinguinal neurectomy for chronic pain. J Neurosurg. 2010;112(4):784–9.CrossRefPubMedGoogle Scholar
  35. 35.
    Hahn L. Treatment of ilioinguinal nerve entrapment – a randomized controlled trial. Acta Obstet Gynecol Scand. 2011;90(9):955–60.CrossRefPubMedGoogle Scholar
  36. 36.
    Rosario DJ, Jacob S, Luntley J, Skinner PP, Raftery AT. Mechanism of femoral nerve palsy complicating percutaneous ilioinguinal field block. Br J Anaesth. 1997;78(3):314–6.CrossRefPubMedGoogle Scholar
  37. 37.
    Johr M, Sossai R. Colonic puncture during ilioinguinal nerve block in a child. Anesth Analg. 1999;88(5):1051–2.CrossRefPubMedGoogle Scholar
  38. 38.
    Vaisman J. Pelvic hematoma after an ilioinguinal nerve block for orchialgia. Anesth Analg. 2001;92:1048–9.CrossRefPubMedGoogle Scholar
  39. 39.
    Hibner M, Desai N, Robertson LJ, Nour M. Pudendal neuralgia. J Minim Invasive Gynecol. 2010;17(2):148–53.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  • Natalia Murinova
    • 1
    Email author
  • Daniel Krashin
    • 2
  • Andrea M. Trescot
    • 3
  1. 1.Department of Neurology, Headache ClinicUniversity of WashingtonSeattleUSA
  2. 2.Pain and Anesthesia and Psychiatry Departments, Chronic Fatigue ClinicUniversity of WashingtonSeattleUSA
  3. 3.Pain and Headache CenterAnchorageUSA

Personalised recommendations