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SBA Answers and Explanations
Published in Vivian A. Elwell, Jonathan M. Fishman, Rajat Chowdhury, SBAs for the MRCS Part A, 2018
Vivian A. Elwell, Jonathan M. Fishman, Rajat Chowdhury
The ilioinguinal nerve innervates the muscles of the lower abdomen, specifically the skin overlying the inguinal region, upper part of the thigh, and anterior third of the scrotum or labia in women. This nerve is at risk in the muscle-splitting incision made for appendicectomy. Damage during appendicectomy would lead to the inability to pull the falx inguinalis over the thin area of weak fascia on the posterior wall of the inguinal canal, thereby predisposing the patient to develop a direct inguinal hernia.
The Stomach (ST)
Published in Narda G. Robinson, Interactive Medical Acupuncture Anatomy, 2016
Ilioinguinal nerve (L1): Travels through the inguinal canal. Innervates the skin of the upper scrotum or labium majus, root of the penis, mons pubis, and nearby medial thigh. Also supplies the internal oblique and transversus abdominis muscles. The ilioinguinal nerve is involved in the afferent limb of the cremasteric reflex, along with the genitofemoral nerve (L1,L2). Branches of the ilioinguinal nerve include the anterior scrotal in males and the labial in females. Damage to the ilioinguinal nerve has been called an “infamous complication of inguinal hernia surgery.”7
Chronic pelvic pain
Published in Peter R Wilson, Paul J Watson, Jennifer A Haythornthwaite, Troels S Jensen, Clinical Pain Management, 2008
Stabbing, sharp pain, typically elicited by exercise and chronic dull aching pain that is relieved by bed-rest, may reflect nerve entrapment.113, 115 In a series of 46 women with a clinical diagnosis of ilioinguinal nerve entrapment, 88 percent had hyperesthesiae and 53 percent dysesthesia.116 The site of maximal pain with ilioinguinal or iliohypogastric nerve entrapment is along the lateral edge of the rectus margin and may radiate to the hip or sacroiliac region.
Non-pharmacological treatments for chronic orchialgia: A systemic review
Published in Arab Journal of Urology, 2021
Kareim Khalafalla, Mohamed Arafa, Haitham Elbardisi, Ahmad Majzoub
The present review identified 19 individual studies including 1676 testicular units for which MSCD was performed. In most cases an open approach for surgery was performed (inguinal [n = 14]; subinguinal [n = 3]; Table 1) [9–27]. Depending on the level of the incision, the aponeurosis of the external oblique muscle is either spared or opened. The ilioinguinal nerve is identified and a 2 cm segment is excised and ligated with proximal part buried well to avoid neuroma formation. Under microscopic magnification, the spermatic cord is brought up and its fascia is opened to expose the cord contents. Micro-Doppler ultrasonography (US) is used to identify the arterial flow in attempt to preserve testicular and cremasteric arteries during the procedure. The contents of the cord are ligated and dissected, which includes the cremasteric fascia, spermatic cord fat, and the pampiniform plexus of veins. Lymphatics are preferably spared to avoid hydrocele formation. The vas deferens is also preserved to reduce epididymal congestion, which decreases the incidence of post-vasectomy pain syndrome (PVPS). However, stripping of the perivasal tissues is performed to ensure obliteration of all the neural fibres.
Penile reconstruction: An up-to-date review of the literature
Published in Arab Journal of Urology, 2021
Nicholas Ottaiano, Joshua Pincus, Jacob Tannenbaum, Omar Dawood, Omer Raheem
A RFFF is a viable surgical option for penile reconstruction due to the predictable anatomy of the flap, pliable skin, and well-developed vessels [37] (Figure 5). The RFFF is harvested from the forearm and shaped to the phallus using the tube-within-a-tube technique wherein two skin paddles are rolled in opposing directions with a dermal vascular supply between the layers to supply the urethral skin paddle. An additional skin flap is then used to create a corona to mimic a circumcised glans. After anastomosing the urethra, the free flap is moved into place on the pubic area for the radial artery to be connected in an end-to-side fashion to the common femoral artery via microsurgical technique. The anastomosis of the venous drainage is also made microsurgically between the greater saphenous vein and the cephalic vein. Additionally, a cutaneous nerve, often the medial cutaneous nerve of the forearm, is connected to the ilioinguinal nerve to maintain protective sensation, while the dorsal penile nerve is connected to another nerve to achieve erogenous sensation [38].
Intraoperative Neuromonitoring and Lumbar Spinal Instrumentation: Indications and Utility
Published in The Neurodiagnostic Journal, 2021
Ryan C. Hofler, Richard G. Fessler
Neurologic injuries following the anterior approach to the lumbar spine include specific nerve root syndromes, equine cauda syndrome, injury to the genitofemoral or ilioinguinal nerves, and most commonly, hypogastric plexus injury. Serious complications such as death (0.3%) and paraplegia (0.2%) are rare (Faciszewski et al. 1995). Vascular injury may also lead to neurologic compromise during these approaches due to neural ischemia. In addition to direct arterial injury, arterial thromboembolism due to retraction on the arterial wall has been described as a cause of postoperative weakness and sensory deficit (Chang et al. 2003; Hackenberg et al. 2001; Kulkarni et al. 2003). Genitofemoral and ilioinguinal nerve injuries typically present as post-operative numbness in the groin or medial thigh region. These are more common with surgery to the upper lumbar levels and frequently resolve spontaneously with observation alone (Chow et al. 1980).