Ilioinguinal Neuralgia after Abdomnial Hysterectomy

[jojostarbuck]

On November 16, 2005 I had a total abdominal hysterectomy and it resulted in me having Ilioinguinal neuralgia.  This has caused me to have a horrible throbbing/pulsating pain in the left side of my pelvis from my mons pubis to the top of my Iliac Crest.  The pain clinic has tried multiple trigger point injections, steroid injections, nerve blocks, pulsed radio frequency nerve ablations, etc.  I went to physical therapy for almost two years, etc.  Nothing has helped stop this AWFUL pain!  I manage it now with Lyrica and Oxycontin.  Now my Neurologist has recommended me to have surgery to have the nerve severed.  I am not sure that I want to have this done because from what I have read, cutting the nerve could lead to further problems, more pain, formation of a neuroma, etc, etc.

Also I know that I would have a permanent numb area in my pelvis, which is fine with me, but I cannot find any information about the specific functions of the Ilioinguinal nerve?  I am worried about negative sexual side effects from cutting the ilioinguinal nerve, balance problems in my pelvic area, etc.  What information can you give me about the functions of the ilioinguinal nerve itself?  Because once I have the nerve cut I know that will be final!! But I don't want to take Lyrica and Oxycontin for the rest of my life, I am only 46 years old. . .

[medicalevaluation]

in my opinion, do not have the nerve severed or ablated.  There will never be a chance it will regenerate if that happens.  Have you thought about stem cell therapy from your own stem cells that regenerate nerve endings.  There may be clinical trials.  I was considering nerve ablation of the pudendal nerve, and I found out that any organ that the nerve is attached to and is ablated will atrophy so if it is attached to the bladder or bowel, you may have fecal and urinary incontinence for the rest of your life.  Also, I too live with pain from a gynecological surgery.  I found the combination of Amitriptyline and Topamaxx with Valium or Zanaflex to relax the muscles have given me the most relief. Also, I am considering steroid injections to the nerve to help with the pain, but not Kenalog.  There are pudendal nerve specialist that you can google.  Dr. Conway in New Hampshire can diagnose nerve pain and his colleague gives injections.  There are a few across the country.  Just google pudendal nerve information

[dr_simran]

Hello jojostarbuck,
Injury to the ilioinguinal nerve commonly follows during lower abdominal and pelvic surgery, especially with inguinal hernia repair, appendectomy, and hysterectomy. Appropritate treatments range from conservative management with nonopioid eg, gabapentin, topiramate as well as opioid agents, to surgical neurectomy of the proximal portion of the ilioinguinal nerve. Pharmacological treatment is frequently unsuccessful particularly if delayed and while surgery is successful in approximately 73% of cases, it can result in problematic paresthesias, and pain may continue to persist in some patients. Thus, minimally invasive techniques, such as peripheral nerve stimulation, may be viable in those patients who are refractory to pharmacological management, as an option to surgery, and who have not gained satisfactory pain relief through surgical intervention.  Neurostimulation has  potential benefits including durable effective pain relief and decreased use of medication.You should consult your surgeon regarding the peripheral nerve stimulation as it is noninvasive and effective.
Reference http://www3.interscience.wiley.com/journal/119422366/abstract
Best