Surgical treatment of intractable pelvic, groin, and perineal neuropathic pain in a gynaecologic patient: triple neurectomy

Scott A. Farrell, Marie-Eve Clermont
Journal of Obstetrics and Gynaecology Canada · 2015 · vol. 37(2) , pp. 145–149 · doi:10.1016/s1701-2163(15)30336-4 · PMID:25767947 · W2237121589
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A triple neurectomy of the iliohypogastric, ilioinguinal, and genitofemoral nerves completely resolved severe neuropathic pelvic pain in a woman with extensive prior lower abdominal surgery.

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Abstract

BACKGROUND: Gynaecologists who are asked to assess patients with pain in the genital area are not generally trained to consider neurogenic causes for the pain, nor are they generally familiar with the surgical procedures that can eliminate this pain. CASE: A 54-year-old woman who had undergone multiple laparotomies for Caesarean section, abdominal hysterectomy, treatment of ovarian cysts, and lysis of adhesions through a transverse abdominal approach presented with a seven- to eight-month history of severe neuropathic left-sided groin, labial, and perineal pain. Neurectomy involving the iliohypogastric, ilioinguinal, and genitofemoral nerves was performed. Postoperatively the patient experienced complete resolution of the pain. CONCLUSION: Neuropathic pain should be considered in the differential diagnosis of women with an extensive history of lower abdominal surgery. Neurectomy is an effective treatment for this.

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MeSH descriptors

Denervation Neuralgia Denervation Female Groin Groin Humans Middle Aged Neuralgia Perineum Perineum

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