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Ilioinguinal and Genitofemoral Neuralgia

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Urogenital Pain

Abstract

Genitofemoral and ilioinguinal neuralgia are common causes of pelvic pain and should be included in the differential for inguinodynia (groin pain), especially in patients with risk factors such as recent pelvic or abdominal surgery, poorly controlled diabetes, or obesity. Different neuralgias are characterized by a different and somewhat specific distribution of pain; however, there are considerable variations in the course of both nerves which can result in changes in the distribution of innervation and thus changes in the distribution of pain (Cesmebasi et al. Clin Anat 28:128–135, 2015; Rab et al. Plast Reconstr Surg 108(6):1618–1623, 2001). Genitofemoral, ilioinguinal, and iliohypogastric nerves are known as border nerves, since they supply sensory innervation at the border of the abdomen and the thigh region (Peng and Tumber Pain Phys 11:214–224, 2008). Injury to these nerves results in pain and paresthesias in the groin region, which due to the proximity and anatomic variability of the course of the nerves makes it difficult to tease apart the truly injured nerve (Acar et al. Turk Neurosurg 23(6):753–757, 2013; Amid et al. J Am Coll Surg 213:531–536, 2011; Cesmebasi et al. Clin Anat 28:128–135, 2015; Rab et al. Plast Reconstr Surg 108(6):1618–1623, 2001). Also due to the proximity and similar course, these nerves are at risk for injury from the same types of surgeries or traumas. All three originate from the lumbar plexus, making the diagnosis quite challenging. The appropriate treatment plan relies on an accurate diagnosis. Different modalities for treatment exist, many of which are still being investigated.

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References

  1. Acar F, Ozdemir M, Bayrakli F, Cirak B, Coskun E, Burchiel K. Management of medically intractable genitofemoral and ilioinguinal neuralgia. Turk Neurosurg. 2013;23(6):753–7. doi:10.5137/1019-5149.JTN.7754-12.0.

    PubMed  Google Scholar 

  2. Alfieri S, Amid PK, Campanelli G, Izard G, Kehlet K, Wijsmuller AR, Di Miceli D, Doglietto GB. International guidelines for prevention and management of postoperative chronic pain following inguinal hernia surgery. Hernia. 2011;15:239–49.

    Article  CAS  PubMed  Google Scholar 

  3. Alfieri S, Rotondi F, Di Giorgio A, Fumagalli U, Salzano A, Di Miceli D, Ridolfini MP, Sgagari A, Doglietto G. Influence of preservation versus division of ilioinguinal, iliohypogastric, and genital nerves during open mesh herniorrhaphy: prospective multicentric study of chronic pain. Ann Surg. 2006;243:538–53.

    Article  Google Scholar 

  4. Amid PK. Causes, prevention and surgical treatment of postherniorrhaphy neuropathic inguinodynia: triple neurectomy with proximal end implantation. Hernia. 2004;8(4):343–9.

    Article  CAS  PubMed  Google Scholar 

  5. Amid PK, Chen DC. Surgical treatment of chronic groin and testicular pain after laparoscopic and open pre peritoneal inguinal hernia repair. J Am Coll Surg. 2011;213:531–6.

    Article  PubMed  Google Scholar 

  6. Bonwich JB. Persistent groin pain following hernia repair and post-herniorrhaphy neuralgia. UptoDate; 2013. https://www.uptodate.com. Accessed 14 Sept 2015

  7. Byrd D, Mackey S. Pulsed radiofrequency for chronic pain. Curr Pain Headache Rep. 2008;12(1):37–41.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Campos NA, Chiles JH, Plunkett AR. Ultrasound-guided cryoablation of genitofemoral nerve for chronic inguinal pain. Pain Physician. 2009;12:997–1000.

    PubMed  Google Scholar 

  9. Cesmebasi A, Yadav A, Gielecki J, Shane Tubbs R, Loukas M. Genitofemoral neuralgia: a review. Clin Anat. 2015;28:128–35.

    Article  PubMed  Google Scholar 

  10. Cohen SP, Foster A. Pulsed radiofrequency as a treatment for groin pain and orchialgia. Urology. 2003;61(3):645.

    Article  PubMed  Google Scholar 

  11. DeSantana JM, Santana-Filho VJ, Guerra DR, Sluka KA, Gurgel RQ, da Silva Jr WM. Hypoalgesic effect of the transcutaneous electrical nerve stimulation following inguinal herniorrhaphy: a randomized, controlled trial. J Pain. 2008;9(7):623–9. doi:10.1016/j.jpain.2008.01.337.

    Article  PubMed  Google Scholar 

  12. Ducic I, Dellon AL. Testicular pain after inguinal hernia repair: an approach to resection of the genital branch of genitofemoral nerve. J Am Coll Surg. 2004;198(2):181–4.

    Article  PubMed  Google Scholar 

  13. Egorova N, Gollub RL, Kong J. Repeated verum but not placebo acupuncture normalizes connectivity in brain regions dysregulated in chronic pain. Neuroimage Clin. 2015;9:430–5. doi:10.1016/j.nicl.2015.09.01.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Finnerup NB, Otto M, McQuay HJ, Jensen TS, Sindrup SH. Algorithm for neuropathic pain treatment: an evidence based proposal. Pain. 2005;118:289–305.

    Article  CAS  PubMed  Google Scholar 

  15. Friedman M, Mikityansky I, Kam A, Libutti SK, Walther MM, Neeman Z, Locklin JK, Wood BJ. Radiofrequency ablation of cancer. Cardiovasc Intervent Radiol. 2008;27(5):427–34.

    Google Scholar 

  16. Gray JE. Nerve injury associated with pelvic surgery. Up to Date; 2013. https://www.uptodate.com. Accessed 14 Sept 2015

  17. Hakeem A, Shanmugam V. Current trends in the diagnosis and management of post-herniorrhaphy chronic groin pain. World J Gastrointest Surg. 2011;3(6):73–81.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Hata J, DeSilva C, Leung D, Betesh N, Luo DZ, Dawodu S, Perret-Karimi D, Sinavsky K, Stokes OJ, English S. Pulsed radiofrequency current in the treatment of pain. Crit Rev Phys Rehabil Med. 2011;23:213–24.

    Article  Google Scholar 

  19. Hollis MH, Lemay DE. Nerve entrapment syndromes of the lower extremities. Medscape; 2016. http://emedicine.medscape.com/article/2225774-overview. Accessed 10 Jan 2016.

  20. 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;15:237–44.

    PubMed  Google Scholar 

  21. Kehlet H. Chronic pain after groin hernia repair. Br J Surg. 2008;95:135–6.

    Article  CAS  PubMed  Google Scholar 

  22. Kehlet H, Jensen TS, Woolf CJ. Persistent postsurgical pain: risk factors and prevention. Lancet. 2006;367:1618–25.

    Article  PubMed  Google Scholar 

  23. Magee RK. Genitofemoral causalgia: (a new syndrome). Can Med Assoc J. 1942;46(4):326–32.

    CAS  PubMed  PubMed Central  Google Scholar 

  24. Martin DC. Pulsed radiofrequency application for inguinal herniorrhaphy pain. Pain Physician. 2006;9(2):153–15.

    Google Scholar 

  25. Murovic JA, Kim DH, Tiel RL, Kline DG. Surgical management of 10 genitofemoral neuralgias at the Louisiana State University Health Sciences Center. Neurosurg. 2005;56(2):298.

    Article  Google Scholar 

  26. Ndiaye A, Diop M, Ndoye JM, Mane L, Nazarian S, Dia A. Emergence and distribution of the ilioinguinal nerve in the inguinal region: applications to the ilioinguinal anesthetic block (about 100 dissections). Surg Radiol Anat. 2010;32(1):55–62.

    Article  PubMed  Google Scholar 

  27. Parris D, Fischbein N, Mackey S, Carroll I. A novel CT-guided transpsoas approach to diagnostic GFN block and ablation. Pain Med. 2010;11:785–9.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Peng PWH, Tumber PS. Ultrasound-guided interventional procedures for patients with chronic pelvic pain - a description of techniques and review of literature. Pain Physician. 2008;11:214–24.

    Google Scholar 

  29. Rab M, Ebmer AJ, 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.

    Article  CAS  PubMed  Google Scholar 

  30. Rozen D, Ahn J. Pulsed radiofrequency for the treatment of ilioinguinal neuralgia after inguinal herniorrhaphy. Mt Sinai J Med. 2006;73(4):716–8.

    PubMed  Google Scholar 

  31. Saldanha DF, Khiantani VL, Carrillo TC, Yap FY, Bui JT, Knuttinen MG, Owens CA, Gaba RC. Current tumor ablation technologies: basic science and device review. Semin Intervent Radiol. 2010;27(3):247–54.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Starling JR, Harms BA. Diagnosis and treatment of genitofemoral and ilioinguinal neuralgia. World J Surg. 1989;13(5):586–91.

    Article  CAS  PubMed  Google Scholar 

  33. Taghavi R, Tabasi KT, Mogharabian N, Asadpour A, Golchian A, Mohamadi S, Kabiri AA. The effect of acupuncture on relieving pain after inguinal surgeries. Korean J Pain. 2013;26(1):46–50.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Terkawi AS, Romdhane K. Ultrasound-guided pulsed radiofrequency ablation of the genital branch of the genitofemoral nerve for treatment of intractable orchialgia. Saudi J Anaesth. 2014;8(2):294–89.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Tsao JCI. Effectiveness of massage therapy for chronic, non-malignant pain: a review. Evid Based Complement Alternat Med. 2007;4(2):165–79.

    Article  PubMed  PubMed Central  Google Scholar 

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Author information

Authors and Affiliations

  1. Saint Francis Hospital, Premier Anesthesia, Wilmington, DE, USA

    Fatimah Habib MD

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  1. Fatimah Habib MD
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Correspondence to Fatimah Habib MD .

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Editors and Affiliations

  1. Department of Anesthesiology, Cooper Medical School of Rowan University , Camden, New Jersey, USA

    Michael Sabia

  2. Department of Anesthesiology, Cooper Medical School of Rowan University, Camden, New Jersey, USA

    Jasjit Sehdev

  3. Center for Advanced Pain Management, Hunterdon Medical Center Center for Advanced Pain Management, Flemington, New Jersey, USA

    William Bentley

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Habib, F. (2017). Ilioinguinal and Genitofemoral Neuralgia. In: Sabia, M., Sehdev, J., Bentley, W. (eds) Urogenital Pain. Springer, Cham. https://doi.org/10.1007/978-3-319-45794-9_2

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  • DOI: https://doi.org/10.1007/978-3-319-45794-9_2

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