COMPARATIVE OUTCOMES OF ILIOINGUINAL NERVE PRESERVATION VERSUS NEURECTOMY IN OPEN MESH INGUINAL HERNIA REPAIR: A PROSPECTIVE STUDY

Abstract

Postoperative pain remains a significant concern after open mesh inguinal hernia repair, with some patients experiencing persistent pain despite NSAIDs and opioids. This study compared ilioinguinal nerve preservation versus neurectomy in terms of postoperative pain and related symptoms. Male patients with uncomplicated unilateral inguinal hernias between the ages of 18 and 70 who were eligible for elective surgery were included in this study (mean age: Group I, 41 years; Group II, 44.7 years). Fifty patients were divided into two equal groups at random over the course of 6 months. Group I had an elective ilioinguinal neurectomy, while Group II had Lichtenstein mesh repair with the ilioinguinal nerve preserved. Individuals with bilateral or recurrent hernias, as well as those under the age of eighteen, were not included. Groin numbness, pain during daily activities, and persistent groin pain were assessed at 1 and 6 months after surgery. Among the 50 patients, each group included 16 patients with right-sided and 9 with left-sided unilateral inguinal hernia. Postoperative VAS pain scores at baseline, 1 month, and 6 months were significantly lower in the ilioinguinal neurectomy group than in the nerve preservation group (P < 0.0001) during normal activity, after rest, coughing, and walking. Immediately after surgery, groin numbness occurred in 4% of patients in both groups. At 1 month, mild groin numbness was reported in 20% of the neurectomy group and 32% of the nerve preservation group, increasing to 72% and 80%, respectively, at 6 months. Ilioinguinal nerve preservation during Lichtenstein mesh repair was associated with a higher incidence of chronic groin pain and postoperative groin numbness compared with prophylactic neurectomy.