Hip / Groin / Leg

Genitofemoral Neuralgia

Definition

Genitofemoral neuropathy is a neurological disorder due to lesions or dysfunction of this nerve and is accompanied by pain and neurological deficits in the region of the genitofemoral nerve.

Aetiology

Genitofemoral neuropathy is caused by a traumatic lesion in lower abdominal incisions, such as the Pfannenstiel incision, Caesarean section, appendectomy, or inguinal hernia surgery, and is due to compression in late pregnancy. In inguinal hernia surgery, 5-53% of patients suffer severe postoperative pain.

Signs and symptoms

The symptoms in genitofemoral neuropathy usually consist of an unpleasant painful feeling in the lower abdomen and groin, with pain radiating to the inner side of the upper leg, scrotum or greater labia. Patients complain of a characteristic burning, stabbing neuropathic pain.

Diagnostics

Physical Examination

Neurological examination, particularly in the region of the genitofemoral nerve, can confirm the diagnosis.

Additional Somatic Diagnostics

  • Diabetes must be excluded.
  • EMG of the genitofemoral nerve.
  • Referral when there is suspicion of other aetiology.
  • RAND-36 (quality of life)
  • VAS Pain (maximal, minimal, actual, average/week)
  • PCS (catastrophising)
  • HADS (fear and depression)

Additional Psycho-cognitive Diagnostics

Multidisciplinary Treatment

Whether or not somatic treatment is indicated is based on the pain diagnosis. Based on the findings of the pain questionnaires, additional diagnostics and/or multidisciplinary treatment consisting of various non-somatic treatments may be necessary.

Non-somatic Treatment

Somatic Treatment

Pharmacological treatment:

  • Tricyclic antidepressants
  • Anticonvulsives: carbamazepine, oxcarbazepine, gabapentine and pregabaline.

Interventional Pain Treatment