Complications of Orchiopexy
Kevin R. Loughlin in Complications of Urologic Surgery and Practice, 2007
The ilioinguinal, iliohypogastric, and genital branch of the genitofemoral nerve are the nerves of concern during orchiopexy. Both the ilioinguinal nerve and the iliohypogastric nerves arise from T12 and L1, and are responsible for sensation to the upper and medial aspects of the thigh and the skin of the base of the penis as well as the anterior portion of the thigh. The ilioinguinal nerve is typically found on the lateral aspect of the spermatic cord. It passes through the superficial inguinal ring to reach the subcutaneous tissues and the skin. The iliohypogastric nerve lies on the internal oblique abdominal muscle and penetrates the aponeurosis of the external oblique muscle near the rectus muscle to reach the subcutaneous tissue and the skin. The genital nerve has both motor and sensory components and innervates the cremaster muscle and the skin of the side of the scrotum. In the inguinal canal it lies on the iliopubic tract and is accompanied by the cremasteric vessels to form a neurovascular bundle that passes through the superficial inguinal ring.
Blocks of Nerves of the Trunk
Bernard J. Dalens, Jean-Pierre Monnet, Yves Harmand in Pediatric Regional Anesthesia, 2019
The ilioinguinal nerve, which is usually smaller than the iliohypogastric nerve, is a branch of the first lumbar spinal nerve issuing just below the previous nerve, and its course is similar to that of the iliohypogastric nerve. It crosses the quadratus lumborum and the iliacus muscle obliquely, pierces the transversus abdominis (at the level of the iliac crest) and the oblique muscles, then reaches the lower border of either the spermatic cord (in the male) or the round ligament of the uterus (in the female), in the inguinal canal (Figure 4.14). It contributes fibers to (1) the internal oblique muscle, (2) the skin of the upper medial part of the thigh, and (3) either the skin of the upper part of the scrotum and the root of the penis or the skin covering the labium majus and the mons pubis.
Complications in Gynecologic Surgery
Stephen M. Cohn, Matthew O. Dolich in Complications in Surgery and Trauma, 2014
Ilioinguinal/iliohypogastric nerve damage can occur during laparoscopic procedures or laparotomy performed through a low transverse abdominal incision. The nerves run laterally through the head of the psoas muscle, then through the transversus abdominis muscle, and terminate in the lower lateral aspect of the anterior abdominal wall.2 Nerve damage in these instances can be the result of direct injury, incorporation into a suture, or late formation of scar tissue and presents as pain and burning at the incision sites, labia, mons, or inner thigh. If recognized, most injuries are reversible with removal of the sutures.3
Postoperative pain and neuropathy after caesarean operation featuring blunt or sharp opening of the fascia: a randomised, parallel group, double-blind study
Published in Journal of Obstetrics and Gynaecology, 2018
Fatma Yazici Yilmaz, Begum Aydogan Mathyk, Serhat Yildiz, Nefise Nazli Yenigul, Ceren Saglam
Not only the VAS scores, but also the incidence of neuropathy, were significantly higher in the sharp group at 1 and 3 months after surgery (p = .043 and p = .016, respectively) (Table 3). Neuropathic pain can be present immediately postoperatively or even weeks to months later; the classical manifestation is a burning pain in the lower abdomen (Cardosi et al. 2002; Whiteside et al. 2003; Rahn et al. 2010). Neuropathy is defined as the loss of sensation, paraesthesia and/or dysesthesia in the known region of distribution of a sensory nerve and/or as weakness in a muscle group supplied by a peripheral nerve. The iliohypogastric nerve supplies sensations to the skin of the glutaeal and hypogastric regions. The ilioinguinal nerve provides sensory innervation to the skin overlying the groyne, inner thigh and labia majora (Stulz and Pfeiffer 1982; Hahn 1989; Whiteside et al. 2003). In this study, the extent of neuropathy was lower in the blunt group than in the sharp group. The patients who developed neuropathy complained particularly about the numbness and hypoaesthesia in the region of the incision.
Effect of perineural bupivacaine infiltration on reducing inguinodynia in patients undergoing inguinal meshplasty – a randomized controlled trial
Published in Acta Chirurgica Belgica, 2022
Angeline Mary Samy, Amaranathan Anandhi, Gubbi Shamanna Sreenath, Sathasivam Sureshkumar, Srinivasan Swaminathan
The ilioinguinal nerve was identified 3 cm medial and 4 cm inferior to ASIS and 3 cm lateral to the midline. The iliohypogastric nerve was identified 1.5 cm inferior to ASIS and 4 cm lateral to midline. The facial plane, which we had injected, was between the internal oblique and transverse abdominis muscle. The fascia here splits to enclose the ilioinguinal and iliohypogastric nerve. It was at this point that the local anesthetic is deposited to block both the ilioinguinal and iliohypogastric nerves. The landmark for the Genitofemoral nerve block was a point medial to the pubic tubercle.
Related Knowledge Centers
- Lumbar Nerves
- Lumbar Plexus
- Skin
- Nerve
- Sensory Nervous System
- Gluteal Muscles
- Hypogastrium
- Abdominal Internal Oblique Muscle
- Transverse Abdominal Muscle
- Ventral Ramus of Spinal Nerve