Diagnosis and management of genitofemoral neuralgia
B. A. Harms, D. R. DeHaas Jr and J. R. Starling
Genitofemoral neuralgia is a syndrome characterized by chronic pain and
paresthesia in the region of genitofemoral nerve distribution.
Genitofemoral nerve entrapment has been described after inguinal
herniorrhaphy, appendectomy, and cesarean section. Failure to distinguish
it from ilioinguinal nerve entrapment can result in unnecessary inguinal
reexploration, or patients severely debilitated from chronic pain. We
recommend that patients with persistent pain and paresthesia in the
inguinal region following surgery should have a local ilioinguinal nerve
block. If this is unsuccessful in affecting relief of symptoms, a
paravertebral block of L-1 and L-2 should be considered. Using these two
blocks, a rational decision can then be made to operate on either the
ilioinguinal nerve or the genitofemoral nerve. We describe three cases of
genitofemoral neuralgia treated by extraperitoneal excision of the
genitofemoral nerve.
