A 58-year-old man undergoes Lichtenstein tension-free mesh repair for a right indirect inguinal hernia. During the procedure, the surgeon meticulously identifies and preserves the ilioinguinal, iliohypogastric, and genital branch of the genitofemoral nerve. What is the most common cause of chronic postoperative inguinodynia if these nerves are entrapped or injured?
- A Neuropathic pain along the distribution of the entrapped nerve ✓
- B Mesh infection presenting as chronic sinus
- C Recurrence at the pubic tubercle
- D Testicular atrophy due to vascular compromise
Correct answer: A. Neuropathic pain along the distribution of the entrapped nerve
Explanation
Chronic post-herniorrhaphy inguinodynia is most commonly caused by entrapment or injury to one of the three nerves of the inguinal canal: ilioinguinal, iliohypogastric, or the genital branch of the genitofemoral nerve. The resulting neuropathic pain follows the sensory distribution of the affected nerve. Mesh infection and testicular atrophy are recognized complications but are not the most common cause of chronic groin pain.
Reference: Bailey and Love's Short Practice of Surgery, 28th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.