Elective Division of Ilioinguinal Nerve in Inguinal Hernioplasty: Remedy for the Morbid Postoperative Inguinal Pain.

OBJECTIVE

To compare the postoperative pain in inguinal hernioplasty, by preserving versus wide elective division of ilioinguinal nerve.

STUDY DESIGN

Randomized controlled trial.

PLACE AND DURATION OF STUDY

Surgical Department, Civil Hospital, Karachi, from January till August 2015.

METHODOLOGY

All patients of either gender above 15 years of age, undergoing mesh repair for unilateral, reducible inguinal hernia, were included. Patients with recurrent inguinal hernia, bilateral inguinal hernia, and those who will require emergency hernia surgeries like irreducible, obstructed, and strangulated hernia, were excluded. They were randomly assigned 42 into inguinal nerve preservation group (group A) and 42 in division (group B). Postoperative pain was assessed at first day, at discharge and after one month using visual analogue scale.

RESULTS

There were a total of 84 patients. Group Apatients had median (IQR) pain scores of 5 (1) and 3 (2) as compared to group B pain scores of 4 (2) and 2 (1) at 24 hours of surgery and at discharge, respectively (p <0.05). Median (IQR) postoperative pain score one month after inguinal hernioplasty was 2.5 (1) in group A, while 0.5 (1) in group B (p <0.05). Asignificant decline in the pain scores were observed in group B from the first day of surgery till one month afterwards (p <0.05).

CONCLUSION

Wide resection of ilioinguinal nerve has a lower frequency of postoperative pain in comparison to the ilioinguinal nerve preservation, in inguinal hernioplasty.