Evaluation of genitofemoral nerve motor conduction in inguinoscrotal pathologies

Does percutaneous internal ring suturing contain risk of ilioinguinal nerve entrapment?

PURPOSE

In this study, we aim to assess the alteration of IIN functions in children with inguinal hernias operated on using open or 'percutaneous internal ring suturing' (PIRS).

METHODS

This study was based on a prospective clinical trial of 60 pediatric patients. They were operated on using PIRS or conventional open hernia repair technique. Group 1 included 35 patients who were treated with PIRS technique. Group 2 included 22 patients who underwent a conventional open hernia repair. The ilioinguinal nerve stimuli in both the operational and non-operational areas were evaluated in patients with peripheral EMG for possible ilioinguinal nerve damage on the hernia side before the operation and to reevaluate ilioinguinal nerve function in the third postoperative week.

RESULT

In Group 1, 19 cases underwent a preoperative EMG examination and in 35 cases, EMG examination was obtained postoperatively. Pre- and postoperative EMG results were normal in all cases in Group 1 on both the operational and non-operational sides. In Group 2, 15 preoperative and 25 postoperative EMG examinations were obtained. In Group 2, only one case with a right inguinal hernia who had normal preoperative EMG results showed no IIN response in a postoperative EMG evaluation obtained in the third postoperative week, with a normal left-side response. The EMG was repeated at the three-month postoperative third mark and revealed the same result. In a six-year-old female case, there was a negative EMG response on the non-operative side both pre- and postoperatively.

Electrophysiologic evaluation of genitofemoral nerve in children with inguinal hernia repair

AIM

Genitofemoral nerve (GFN) injury may occur because of chronic pressure of hernia sac or surgical intervention. A prospective study was performed to evaluate GFN electrophysiologically in children with inguinal hernia repair.

METHODS

Children with inguinal hernia were evaluated for GFN electrophysiologically before and after (3-6 months postoperatively) inguinal hernia repair. Bilateral GFN motor response latencies and durations were investigated electrophysiologically by surface electrodes. Wilcoxon signed ranked test was used for statistical analysis, and P values lower than .05 was considered to be significant.

RESULTS

Eleven patients with a mean age of 4.45 +/- 2.16 were enrolled in the study. Mean latency of patients was 2.37 +/- 0.89 milliseconds preoperatively and 3.14 +/- 1.02 milliseconds postoperatively. Latency of GFN was found prolonged after hernia repair (P = .008). Duration of GFN motor response was 9.94 +/- 1.49 milliseconds and 11.18 +/- 2.44 milliseconds, respectively, in preoperative and postoperative recordings. There was no significant difference detected in mean durations (P > .05).

CONCLUSION

Latency of GFN may prolong after inguinal hernia repair. Prolongation of GFN latency may be the result of surgical injury during hernia repair and consequently also related with chronic groin pain.