A patient undergoing open inguinal hernia repair develops loss of the ipsilateral cremasteric reflex postoperatively. Which nerve, injured during dissection at the deep inguinal ring, is most likely responsible?

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

Explanation

The genital branch of the genitofemoral nerve enters the inguinal canal through the deep ring, runs on the posterior surface of the cord, supplies the cremaster muscle and provides sensation to the scrotum and medial thigh. Injury during dissection at the deep ring abolishes the cremasteric reflex. The ilioinguinal and iliohypogastric nerves run superficial to the internal oblique and cause sensory loss or neuralgia over the groin and suprapubic skin but do not supply the cremaster, so they do not abolish the reflex.

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

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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