Post-herniorrhaphy Neuralgia is commonly related to a persistent inguinal pain following hernia repair that last almost three months after surgery.
Several scientific studies in recent years have shown that this disease is more common than what was believed. In fact, up to 30% of patients operated on inguinal hernia are affected. Of these only less than 2% report an intense and disabling pain that limits normal daily activities. Who is more impressed: 1) Young people (under 40). 2) Those who reported inguinal pain even before surgery. 3) Women. 4) Who had complications during or after surgery or was reoperated for hernia recurrence. In addition, the surgeon's attempts to identify and preserve nerves involved in pain during surgery are associated with a greater percentage of pain. Finally, several scientific papers show that laparoscopic hernia repair reduces the risk of chronic pain compared to the standard "open" technique. DIAGNOSIS The diagnosis is essentially clinical. It may be useful to perform a Tac performed, as demonstrated by recent texts, in the prone position or an MRI, possibly under strain. This is to exclude the presence of other causes or a cynically non-evident recurrence. TREATMENT: As over time many patients spontaneously improve, we tend to follow a treatment protocol that involves three phases in long periods even three months from each other. 1: Medical therapy with drugs that act on the nervous system, in increasing doses and for an adequate period of time. 2: Infiltration with anesthetic and cortisone drugs possibly under ultrasound guidance. Such treatments if effective are repeated. 3: Laparoscopic Neurolysis surgery. It is a treatment reserved for surgeons experienced in laparoscopic techniques that provides the section of nerves involved in pain. A complete anesthesia of the skin of the inguinal area, root of the thigh and part of the scrotum or of the labia majora will persist