Iatrogenic femoral neuropathy subsequent to abdominal hysterectomy: incidence and prevention.

In a prospective study femoral neuropathy occurred in 17 of 147 patients who underwent elective total abdominal hysterectomy, resulting in an overall incidence of 11.6%. The neuropathy was associated with the use of self-retaining retractors of various types. No other contributing factors were found. The duration of complaints ranged from 3 to 65 days. Spontaneous recovery did occur in 15 of 17 patients and, although residual sensory symptoms were noted in 2 patients, no serious sequelae have been observed. Knowledge of the problem is mandatory for prevention. Careful use of any self-retaining retractor, especially one with large lateral blades, is recommended. The prognosis usually is fairly good.