A method for the reduction of chronic pain after tension-free repair of inguinal hernia: iliohypogastric neurectomy and subcutaneous transposition of the spermatic cord

Purpose We assessed the efficacy of iliohypogastric neurectomy and subcutaneous transposition of the spermatic cord and ilioinguinal and genital nerves on the incidence of postoperative chronic pain (PCP) after open inguinal hernia repair with polypropylene mesh. Methods Between October 2006 and November 2006, 54 adult male patients with primary inguinal hernia were randomised into two groups. In group A, we performed Lichtenstein hernia repair, neurectomy and the new procedure; in group B, only Lichtenstein’s operation was performed. Results One month after operation, the incidence rate of PCP was significantly lower in group A. At 6 months, there was no significant difference between both groups regarding PCP at rest and coughing. However, there were no patients who complained of PCP after walking and climbing up stairs in group A. The sensorial changes in the groin region were similar in the two groups. Conclusion This procedure decreases the incidence of physical activity-induced PCP, without increasing the risks of sensory changes.