Genitofemoral neuralgia

[finnegan1]

I have been having groin pains for many years.  It is not clear what triggered this off, though I had been taking blood pressure pills the previous year which had caused some problems with my potency and was under stress at the time from a bad break-up with a ladyfriend.  They started primarily in my left testicle though also with some pain immediately above my genitals.   A testicular inspection was carried out and an appendix testicle removed, though this seemed to make the pain worse.   Various drug treatments were tried, though to little avail - amitriptyline may have had some beneficial effect.   My pain eventually moved away from the testicle but stayed in my groin and sometimes it shoots down towards that testicle.   I was tested for prostatis, but this was negative.   An examination of my prostate was carried out, a small part removed and its position was moved slightly, which seemed to have some beneficial effect.    A further examination revealed some scarring in that area.   I have recently been to a private pain consultant whose view is that I have genitofemoral neuralgia and he is giving me pain block and pain killing injections, the first of which resulted in the pain shooting towards the reverse off my spine.   Has anyone had a similar experience and any suggestions as to further treatment?              

[Tom7335]

I`m a 55 yr old male . Hernia repair right side in 1986. Started having testicular pain
in the 1996 timeframe. 3 yrs ago Urologist administered Nerve Block in Scrotum
which blocked pain for 24 hrs then pain increased dramatically for the next 5 days
and then gradually returned to my previous level of pain. 6 months later another
doctor administered a GBGFN block in the lower part of the Inguinal Canal. This
provided no relief and actually made the pain worse just as you describe in your
3-2-08 post. I would never have another nerve block. After weeks of research on the
Net and the Hershey Medical Center Library I was able to get a referral to Dr Dellon
in Baltimore Md. He is a recognized expert with Peripheral Nerve injuries. His web site
is dellon.com. He developed a procedure involving resecting the nerves, genitofemoral
and illioguinal, to permanently relieve groin pain. He does not accept insurance of any
kind at the Baltimore location. Office visit charge is 500.00. He does have offices
at different locations around the country which may accept insurance if you dont
live near Baltimore. On his site, click on "where does it hurt", then click "Enter", then
Groin pain. You will then get a tutorial on his thesis and procedure. Very few surgeons
in the country have the training to treat Nerve Entrapment. Hope this helps.

[Shawnji]

Hi Tom, i also had genitofemoral neurectomy two weeks bak, with Dr Dellon. But still hav testicular pain in left side. When did u see complete pain relief after surgery? Did u also walk in the pool after surgery?

[finnegan1]

Vanessa, thanks for this.   I have had a couple of blocks, the first described as a "bilateral genitofemoral nerve block with pulsed radiofrequency and cortisone", which I think made things slightly better and then another bilateral block 6 weeks later "using pulsed radiofrequency 50 hertz 1-1.2 volts to find the nerve.  I also checked for no motor stimulation at 2 hertz 1-1.2 volts.  I was able to elicit discomfort on the sensory modality from the genitofemoral nerve.  Each side was given pulsed radiofrequency for 130 seconds to a maximum of 42 degrees centigrade using a BVM radiofrequency machhine.  A total of 100 mg of Depo-Medrone and 10 mls of 0.25% Bupivacaine were also instilled with Lignocaine 1% 4 mls to the skin.   I'm afraid the pain has been worse since this procedure.  

I discussed neurectomy with my specialist.  He said that this could result in short-term pain relief and so was sometimes used in palliative care, but that he would not recommend it in my case, as the nerve often grows back in the wrong way.  

What I don't understand, and I shall be discussing this with the specialist when I see him in a few weeks time, but would welcome any advice in the interim, is why the concentration on the left and right of my groin, when the pain is so clearly right in the middle (though sometimes shoots down towards my left testicle, particularly when my testicles shrivel up, say in cold weather)?          
        

[Vanessa Lacuesta]

Hi,

Genitofemoral neurlagia may follow surgical procedures like appendectomy and hernia repair. However, this has to be differentiated from an ilioinguinal nerve neuralgia.

Since neuralgia may present as a chronic pain, paravertebral blocks of L1 and L2  may help.You may discuss with your physician the risks and advantages involved with a genitofemoral nerve neurectomy which was shown to relieve the pain of genitofemoral neuralgia.

Do keep us posted regading your physician's advise.