Effect of neurectomy versus ilioinguinal nerve preservation in the Lichtenstein tension-free hernioplasty of inguinal hernia

Abstract

Objectives The aim of this study was to evaluate the effect iveness of ilioinguinal neurectomy on postoperative pain in the Lichtenstein tension-free hernioplasty of inguinal hernia. Background Chronic pain following tension-free inguinal hernioplasty is a significant clinical problem that can interfere with normal daily activities. Moreover, the condition can sometimes be debilitating, and treatment is often difficult and challenging. Contrary to the previous belief, division of the ilioinguinal nerve prophylactically during mesh repair has been practiced to reduce the incidence and intensity of persistent postoperative pain after hernia repair. Patients and methods Between April 2015 and October 2016, this prospective, randomized, controlled study included 40 male patients above 18 years of age with unilateral inguinal hernia who were undergoing the Lichtenstein hernia repair. Patients were randomized into two groups – the ilioinguinal neurectomy group and the ilioinguinal nerve preservation group. Twenty patients were included in each group. Patients were followed-up for inguinal postoperative pain at 1 and 6 months using a four-point categorical scale. Groin numbness was also assessed at 1 and 6 months using a self-administered questionnaire. Results There were no statistically significant differences between the two groups with regard to postoperative pain after 1 and 6 months at rest; however, after coughing 10 times, walking up three flights of stairs, and cycling for 10 min, there were statistically significant differences – postoperative pain in group A was 5% and in group B 30% (P Conclusion Ilioinguinal neurectomy should be considered a routine surgical step during the Lichtenstein tension-free hernioplasty.