Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association)
Online ISSN : 1882-5133
Print ISSN : 1345-2843
ISSN-L : 1345-2843
Case Reports
A Case of Chronic Pain after Inguinal Herniorrhaphy Treated Successfully with Mesh Resection and Triple Neurectomy
Ryu MATSUMOTOYoshio NAGAHISAKazuki HASHIDAMitsuru YOKOTAMichio OKABEKazuyuki KAWAMOTO
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2018 Volume 79 Issue 10 Pages 2188-2192

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Abstract
Post-herniorrhaphy chronic pain can lead to a marked decrease in quality of life. We report a case of neuropathic post-herniorrhaphy pain in which mesh resection and triple neurectomy successfully relieved inguinal pain.
A 77-year-old male on dialysis for chronic renal failure underwent open left inguinal herniorrhaphy with the mesh plug method. Three months postoperatively, he complained of left inguinal paresthesia and radiating pain from the left inguinal area to the left thigh. We suspected neuropathic chronic pain associated with herniorrhaphy. Various analgesic therapies failed to relieve the pain, and we performed mesh resection and triple neurectomy at 5 months postoperatively.
The chronic pain was dramatically relieved after surgery. Histopathological findings showed fat necrosis and scarring around the inguinal branch of the inguinal femoral nerve and nerve retraction in the same region. We believe that nerve retraction was one of the reasons for chronic pain.
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© 2018 Japan Surgical Association
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