COMPARATIVE STUDY OF POST OPERATIVE ASSESSMENT OF PAIN IN PATIENT WITH ILIOINGUINAL NERVE PRESERVATION Vs CUTTING IN CASE OF LICHTENSTEIN INGUINAL HERNIA REPAIR

Authors

Mohd Moqeneen Ansari; Boricha Mahavir Jayavantbhai; Parth Mittal; Prem Prakash Sharma Author

Keywords:

Inguinal hernia, Lichtenstein repair, Ilioinguinal nerve, Neurectomy, Chronic groin pain, Postoperative neuralgia, Sensory disturbance.

Abstract

Background: Inguinal hernia is a prevalent surgical condition, with Lichtenstein tension-free mesh repair being the standard treatment. However, chronic postoperative groin pain (PCP) remains a significant complication. Prophylactic ilioinguinal neurectomy has been proposed to reduce chronic pain, though concerns about sensory deficits persist.
Objective: To compare long-term neuralgia and paraesthesia outcomes following routine ilioinguinal nerve excision versus preservation in patients undergoing Lichtenstein inguinal hernia repair.
Methods: This prospective observational study was conducted at the Pacific Institute of Medical Sciences, Udaipur, over 20 months. Sixty-four male patients (aged 18–60 years) undergoing elective Lichtenstein hernioplasty were randomly assigned to two groups: nerve preservation (Group A) and prophylactic neurectomy (Group B). Outcomes assessed included postoperative pain, hypoesthesia, hyperesthesia, and activity-related discomfort. Statistical analysis was performed using SPSS 28.0.
Results: Group B (neurectomy) showed significantly lower rates of chronic pain at all follow-ups. By 3 months, all Group A patients were pain-free, while a few Group B patients reported mild residual pain. Group A had two cases of hypoesthesia and no hyperesthesia, while Group B had transient hyperesthesia that resolved by 3 months. Pain during walking, stair climbing, and vigorous activity was consistently lower and resolved faster in the neurectomy group. No significant differences were observed in other postoperative complications.
Conclusion: Prophylactic ilioinguinal neurectomy during Lichtenstein hernioplasty significantly reduces postoperative groin pain with minimal sensory impairment. It is a safe and effective strategy to enhance patient satisfaction and reduce chronic neuralgia, though informed consent regarding sensory changes is essential.