A randomized controlled study to compare the effect of Ilio- inguinal neurectomy or preservation of the Ilio-inguinal nerve in lichtenstein tension free hernioplasty for inguinal hernia

الملخص EN

Background : Chronic groin pain is a significant problem following tension free hernioplasty with a reported incidence ranging from 19% to 62.9%.

Quality of life studies have shown that chronic pain irrespective of severity can significantly interfere with normal daily activities where the condition can sometimes be debilitating and the treatment is often difficult and challenging.

Objective : To study the effect of prophylactic ilio-inguinal neurectomy on the incidence and severity of chronic groin pain following Lichtenstein tension free hernioplasty for inguinal hernia.

Methods : Forty male patients over 18 years old with unilateral inguinal hernia undergoing Lichtenstein hernia repair were randomized to receive either prophylactic ilio-inguinal neurectomy (group A) or ilio-inguinal nerve preservation (group B) during operation.

The primary outcome was the incidence of chronic groin pain at 6 months.

Secondary outcomes included the incidence of groin numbness assessed by self – filling questionnaire at 6 months All follow up and outcome measures were carried out at 1 and 6 months following surgery.

Results : There were no significant statistical difference between the two groups as regard postoperative pain after 1 and 6 months at rest, after various activities, and at normal daily activities.

No significant intergroup differences were found regarding the incidence of groin numbness at 1 and 6 months after the operation.

Conclusions : Prophylactic ilio-inguinal neurectomy should not be considered as a routine surgical step in hernioplasty as it did not decrease the incidence of postoperative groin pain over nerve preservation.