Anthony Echo, MD
Plastic Surgeon & Reconstructive Surgeon located in Houston, TX
After surgery to repair an inguinal hernia, about 15% of patients develop chronic and often severe groin pain. This pain condition often occurs due to nerve damage and is best treated with surgery from Anthony Echo, MD, a skilled microsurgeon. Many patients achieve significant if not complete pain relief thanks to Dr. Echo’s advanced training in complex peripheral nerve surgery, including triple denervation for groin pain. To learn more about this procedure, book an appointment online or call the office in Houston Methodist Hospital or the Willowbrook neighborhood of Houston, Texas.
Triple Denervation for Groin Pain Q&A
When might I need triple denervation for groin pain?
Triple denervation is a procedure to treat chronic groin pain that develops after having surgery to repair an inguinal hernia. Though everyone has some post-surgery groin pain, it should go away within a few weeks.
When your postoperative pain lasts longer than three months, the pain is considered chronic because the nerves in the inguinal area are scarred or injured. This condition is called post-herniorrhaphy neuralgia or inguinodynia.
You can develop chronic groin pain after inguinal hernia surgery regardless of the type of repair. You’re equally at risk for the condition whether you had laparoscopic, robotic, open, mesh, or a no-mesh hernia repair.
What causes chronic groin pain?
During an inguinal hernia repair, a surgeon places the protruding tissues back in their normal position and repairs and stitches together the abdominal wall. In some cases, they insert mesh to strengthen the muscle wall.
Chronic groin pain following inguinal hernia repair typically develops when the nerves in the inguinal canal are injured or entrapped. You may also have mesh complications or scar tissue that affect the nerves.
What symptoms indicate I need triple denervation for groin pain?
Three primary nerves run through the inguinal canal; the ilioinguinal, the iliohypogastric, and the genitofemoral nerves. One or more of these nerves may be damaged and cause significant pain. The nerves may have been stretched by the hernia sac or they may stick to the mesh used during your hernia repair.
Once the nerve adheres to the mesh, you feel electric-shock pain every time you twist, turn, or move in a certain direction.
The damaged nerves may cause symptoms such as:
- Radiating pain
- Burning sensation in the treated area
- Foreign body sensation in the area
- Pain in your testicles
- Pain when walking
You may also experience pain during sexual intercourse.
A triple denervation procedure can treat all these symptoms.
How is chronic groin pain treated?
The first line of treatment for chronic groin pain includes conservative options such as pain medication, nerve blocks, and nerve ablation. However, these treatments typically fail to provide long-lasting pain relief. That’s why it’s important to know you have treatment options such as surgery.
When your pain persists despite conservative measures, Dr. Echo recommends groin denervation surgery to correct the problem. When all three nerves need treatment, you have triple denervation surgery.
What happens during triple denervation for chronic groin pain?
Before your surgery, Dr. Echo performs a diagnostic procedure to verify denervation surgery is your best treatment. He finds the maximal area of pain in the groin crease, which in turn identifies the nerve causing your pain. Then he performs a nerve block, injecting a local anesthetic at the targeted nerve.
If the anesthetic relieves your groin pain within 5-10 minutes, it verifies that the treated nerve is the source of your pain. The amount of pain relief you receive from the nerve block also indicates what you can expect from denervation surgery.
After you have a successful nerve block, Dr. Echo can perform the triple denervation using open surgery. He locates the nerves and determines if they’re healthy. He preserves normal nerves and removes scarred or injured nerves.
Since the nerves are too small to be preserved, Dr. Echo trims the damaged nerves and relocates them deep into the muscle or abdominal cavity, where they no longer cause pain.
After triple denervation surgery, the inguinal area and groin crease feel numb, which is a significant improvement over chronic groin pain. The procedure does not affect your genitals, sexual function, or sensation of the external genitalia.
If you suffer from chronic groin pain after an inguinal hernia repair, call Anthony Echo, MD, or book an appointment online.
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