Neuralgische pijn, een niet te onderschatten complicatie van een liesbreukoperatie volgens de methode van Lichtenstein

Klinische les
D.H. de Lange, A.R. Wijsmuller, Th.J. Aufenacker, J.A. Rauwerda en M.P. Simons

Neuralgic pain, a significant complication after a Lichtenstein procedure for inguinal hernia repair.

- Two male patients, aged 37 and 56, suffered from neuralgic pain after a Lichtenstein procedure for inguinal hernia repair using prosthetic reinforcement. Since mesh-based repair techniques have decreased the recurrence rate, postoperative inguinal pain has become a major complication of these operations. Three months after surgery, 20 of the patients experience some pain. In 12 of the patients this pain limits daily activities and 1-3 of the patients are invalidated by neuralgic pain. Preventing damage to sensory nerves during the operation is one way of preventing neuralgic pain. Damaged sensory nerves should be excised. Neuralgic pain after the operation may be alleviated by tricyclic antidepressants, opioids or antiepileptic drugs. In selected patients with neuralgic pain neurectomy is indicated. In one of the patients presented the neuralgic pain disappeared after neurectomy of the ilioinguinal nerve. Triple neurectomy in the other patient, however, was unsuccessful.

Ned Tijdschr Geneeskd. 2008;152:2205-9