During an open inguinal hernia repair, after opening the external oblique aponeurosis the surgeon dissects around the cord at the deep inguinal ring. Postoperatively the patient reports absent cremasteric reflex and reduced sensation on the anterior scrotal skin. Which nerve was most likely injured?

• A Ilioinguinal nerve
• B Genital branch of the genitofemoral nerve ✓
• C Iliohypogastric nerve
• D Lateral cutaneous nerve of the thigh

Explanation

The genital branch of the genitofemoral nerve enters the inguinal canal through the deep ring, travels on the posterolateral surface of the cord, supplies cremaster motor fibres and carries sensation from the anterior scrotum and medial thigh. Injury at the deep ring produces exactly this combination. The ilioinguinal nerve runs more superficially on the cord and supplies the root of the penis and upper medial thigh, not the cremaster reflex.

Reference: Gray's Anatomy for Students, 4th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.