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PULSED RADIOFREQUENCY TREATMENT OF THE ILIOINGUINAL NERVE FOR CHRONIC INGUINAL PAIN
ESRA Academy. Vriens D. Sep 9, 2016; 138507
Topic: PAIN THERAPY (ACUTE - CHRONIC)
Mrs. Debby Vriens
Mrs. Debby Vriens

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Abstract
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Background and Aims:

Chronic inguinal pain has been reported after pelvic surgery [1] and may be secondary to fibrous adhesions, neuroma formation or suture placement. [2]

We describe our experience with ultrasound guided pulsed radiofrequency (PRF) treatment of the ilioinguinal nerve (IIN) as a possible treatment for chronic inguinal pain.

Methods:

Seventeen patients were retrospectively included from October 2014 to March 2016. Seven presented after herniorrhaphy, two had urologic surgery, one had gynecological surgery and four presented after multiple surgeries. We also included three patients with chronic lower abdominal pain without recent surgery.

A high-frequency linear ultrasound transducer was placed in an oblique orientation along a line connecting the anterior superior iliac spine (ASIS) and the umbilicus. The ilioinguinal and iliohypogastric nerves were visualized between the internal oblique and transverse or external oblique muscles, within 1 to 3 cm from the ASIS. [3, 4] The needle was positioned with ultrasound guidance and confirmed by sensory threshold (≤ 0,3mA). PRF was performed, after a diagnostic block.

Results:

Nine patients (52,9%%) showed clear improvement. Patients presenting after herniorrhaphy showed best improvement (71,4%).

Five participants (29,4%) reported minimal or intermittent improvement, three of them presenting after multiple surgeries, one after inguinal hernia repair, one after urologic surgery.

Three (17,6%) patients showed no benefit. 

Conclusions:

Ultrasound guided PRF treatment of the ilioinguinal nerve may be considered as a valid treatment option in patients presenting with chronic groin pain, especially in those after inguinal hernia repair.

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