Original Scientific ArticlesMesh inguinodynia: a new clinical syndrome after inguinal herniorrhaphy?
Section snippets
Methods
One hundred seventeen patients from the United States underwent remedial groin exploration for chronic inguinodynia after referral to the senior author between 1994 and 1997. Of these patients, 20 had previous mesh herniorrhaphy with chronic inguinodynia and had mesh removal. Only patients with previous mesh herniorrhaphy and chronic inguinodynia were reviewed. All patient records were reviewed, and 15 patients were contacted to evaluate outcomes at least 1 month after remedial surgery.
Results
Our study patients included 17 males and 3 females as shown in Table 1. The age range was from 20 to 71 years with an average of 42 ± 3.4 years. Twelve remedial explorations were right-sided and eight left-sided. All had previous mesh herniorrhaphy with 3 patients having their primary repair performed laparoscopically. In addition to inguinodynia, 13 patients reported pain into the scrotum or labia majora and 2 patients reported pain into the anterolateral thigh (meralgia paresthetica). Eight
Discussion
Inguinal neuralgia, neuropathy, or inguinodynia is now a well-described, albeit rare, complication of inguinal herniorrhaphy. Initial reports date back to the 1940s,1, 2 describing genitofemoral causalgia. Since then multiple reports have appeared in the literature. The incidence of persistent pain has been estimated at 1% to 2%.3 Hagen and coworkers13 reported that 10.6% of patients having open inguinal herniorrhaphy (especially McVay Cooper’s ligament repair) complained of moderate or severe
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