Volume : 5, Issue : 2, February - 2016

Mesh Inguinodynia: A follow up study of three stitch meshplasty

Bhavinder Arora

Abstract :

<p>&nbsp;Background: Patients undergoing inguinal hernia surgery commonly undergoing Lichtenstein meshplasty are common sufferers of chronic inguinal pain. This inguinodynia can be due neuropraxia or neurotemesis of the nerves in the inguinal canal. The second cause is fiosis related to mesh which may lead to narrowing of the internal ring. There can be non neurogenic cause also in some patients. Treatment with analgesics and neuromodulators is effective in most of patients. Mesh removal and neurectomy is advised in those patients who are not cured with analgesics and nerve block even after one year post operative. Material and method: Four hundred patients operated for inguinal hernia were followed in surgical out door. A modified Lichtenstein tension free repair was done using polypropyelene mesh. Patients were followed up for inguinal pain at 1 week, 4 weeks and 3 months duration. A total for 15 patients suffered from inguinal pain at 3 months duration. Only five patients were considered for exploration. All these patients mesh was removed along with neurectomy by open surgery technique. Results: At 1 week follow up these patients had mild to moderate pain. Follow up at 3 weeks sixty patients had some pain. Out of these sixty patients, forty five had pain relief with drugs at the end of 3 month follow up. Symptoms persisted in rest of fifteen patients. Ten of the patients had relief of inguinodynia. The remaining 5 patients were further followed. At end of one year, on exploration mesh was removed in these patients along with neurectomy. All the patients had satisfactory results. Conclusion: Nerve block can relieve inguinodynia but mesh removal combined with neurectomy will cure this mesh inguinodynia</p>