Hazewinkel Menke H, Hinoul Piet, Roovers Jan-Paul
Department of Gynaecology, Academic Medical Center, Amsterdam, The Netherlands.
Int Urogynecol J Pelvic Floor Dysfunct. 2009 Mar;20(3):363-5. doi: 10.1007/s00192-008-0714-8. Epub 2008 Sep 4.
Groin pain after a tension-free vaginal tape-obturator (TVT-O) procedure can occur but mostly disappears within 4 weeks. Persistent groin pain is extremely rare and there is a paucity of literature on how to diagnose and manage this adverse event. We present two cases with severe persistent groin pain after uncomplicated TVT-O, in which magnetic resonance imaging and electromyography did not reveal the cause. We concluded that the tape entrapped or cut through peripheral branches of the obturator nerve. We removed as much of the tape as possible in both cases. Removal partially relieved the pain although sensory loss of the obturator nerve persisted 1 year after surgery. In case of abnormal post-operative groin pain, soon removal of the tape enhances the chance that damage to the obturator nerve is reversible, although it is important to counsel patients with similar pathology that recovery can take long and may be only partial.
无张力阴道吊带闭孔术（TVT - O）后可能会出现腹股沟疼痛，但大多在4周内消失。持续性腹股沟疼痛极为罕见，关于如何诊断和处理这一不良事件的文献也很少。我们报告两例在简单的TVT - O术后出现严重持续性腹股沟疼痛的病例，磁共振成像和肌电图检查均未发现病因。我们得出结论，吊带压迫或切断了闭孔神经的外周分支。我们在两例病例中都尽可能多地移除了吊带。虽然术后1年闭孔神经的感觉丧失仍然存在，但移除吊带部分缓解了疼痛。对于术后腹股沟疼痛异常的情况，尽早移除吊带可增加闭孔神经损伤可逆的机会，不过向有类似病变的患者说明恢复可能需要很长时间且可能只是部分恢复是很重要的。
