Groin / Hernia Pain

Groin pain following hernia repair

Following hernia surgery, some people will complain of chronic pain in the lower abdomen, front or inside of the thigh, and/or the penis, scrotum or labia. There are three small nerves in the area where the hernia was that can be stretched, cut or caught up in scar, and lead to sharp, burning, stabbing, electric shock pains in these areas. In some cases, there is “urgency” or frequency to urinate as well. This is chronic peripheral nerve pain.

Groin pain following injury

The same three nerves that can be injured during hernia repair may be the cause for chronic pain after a car accident, a fall, or other traumatic events. These nerves may suffer permanent damage due to stretch, by scarring, or from bruising caused by the accident.

Abdomen – The iliohypogastric nerve is carries sensation to the skin of the lower flank and abdomen.
Inner thigh and groin – The ilioinguinal nerve passes through a tunnel between the inguinal rings and leads to the skin over the pubic bone and the labia majora or scrotum.
Thigh, groin and genitalia – The genitofemoral nerve can be injured and cause pain in the groin, genitalia and/or perineum. The nerve splits into two branches – the femoral branch, which goes to the skin of the thigh below groin crease, and the genital branch, which goes to the skin of the scrotum or labia.

Can groin nerve pain be treated surgically?

The first thing to do is to make sure that the pain is being caused by one or several nerves, as above. To do this, the doctor takes three steps into account:

Your description of the pain and where it is.
An exam of the area, noting areas of numbness and tenderness.
An ultrasound-guided “block” ** of the nerves can confirm which nerves are involved, and where they are injured.

** Drs. Brown and Hagan have specific expertise in diagnosing nerve injuries that are causing chronic pain, and have significant experience with ultrasound examination and nerve blocks to make the correct diagnosis. This ability adds another level of precision to making sure that surgery is indicated, and that the likely outcome will be significant or complete pain relief.

Once the diagnosis of nerve injury is clear, an operation can be helpful in creating long-lasting relief. Under general anesthesia and outpatient (going home the same day), the surgeon will cut the injured nerve(s) above the area of injury. This will cause a trade-off of numbness in place of the pain.