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Management of Postherniorrhaphy Chronic Neuropathic Groin Pain: A Role for Dorsal Root Ganglion Stimulation.

Chronic neuropathic groin pain is a sequela of hernia surgery that occurs at unacceptably high rates, causing widespread impacts on quality of life. Although the medical community is beginning to recognize the role of surgical technique in the initiation and maintenance of postherniorrhaphy neuropat...

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Published in:Pain Practice Vol. 16; no. 7; pp. 915 - 924
Main Authors: Liem, Liong, Mekhail, Nagy
Format: algorithm diagnostic images review tables/charts Journal Article
Published: Wiley-Blackwell Sep2016
Online Access:View this record in EBSCOhost
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      dt: Sep2016
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        10.1111/papr.12424
        117923471
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        atl: Management of Postherniorrhaphy Chronic Neuropathic Groin Pain: A Role for Dorsal Root Ganglion Stimulation.
      aug:
        au:
          Liem, Liong
          Mekhail, Nagy
        affil: Sint Antonius Ziekenhuis, Nieuwegein The Netherlands
      sug:
        subj:
          Hernia, Inguinal Surgery
          Groin Pain
          Chronic Pain
          Spinal Nerve Roots
          Pain
          Pain Management
      ab: Chronic neuropathic groin pain is a sequela of hernia surgery that occurs at unacceptably high rates, causing widespread impacts on quality of life. Although the medical community is beginning to recognize the role of surgical technique in the initiation and maintenance of postherniorrhaphy neuropathic pain, little information exists regarding pain management strategies for this condition. This review presents a summary of the pain condition state, its treatment options, and treatment recommendations. Both literature review and clinical experience were used to develop a proposed a treatment algorithm for the treatment of postherniorrhaphy pain. The development of chronic pain may be prevented via a number of perioperative measures. For pain that is already established, some surgical approaches including inguinal neurectomy can be effective, in addition to standard pharmacological treatments and local infiltrations. An unmet need may still exist with these options, however, leaving a role for neuromodulation for the treatment of intractable cases. A pain management algorithm for iterative interventions including stimulation of the dorsal root ganglion ( DRG) is described. It is expected that cross-disciplinary awareness of surgeons for nonsurgical pain management options in the treatment of chronic neuropathic postherniorrhaphy pain will contribute to better clinical outcomes.
      pubtype: Academic Journal
      doctype:
        algorithm
        diagnostic images
        review
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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