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Case Reports
. 2012 Feb;119(2 Pt 2):428-431.
doi: 10.1097/AOG.0b013e31822c96cb.

Genitofemoral and perineal neuralgia after transobturator midurethral sling

Brent A Parnell  1 , Elisabeth A Johnson, Denniz A Zolnoun
Affiliations
Case Reports

Genitofemoral and perineal neuralgia after transobturator midurethral sling

Brent A Parnell et al. Obstet Gynecol. 2012 Feb.

Abstract

Background: Midurethral slings successfully treat stress urinary incontinence through a minimally invasive vaginal approach. Postoperative pain related to sling placement can occur and poses both diagnostic and treatment dilemmas.

Case: Four years after transobturator midurethral sling placement, the patient presented with complaints of left labial pain and dyspareunia since surgery. Using sensory mapping and a nerve stimulator, the problem was identified in the distribution of the genitofemoral nerve. Conservative therapy with a centrally acting neuromodulatory drug and nerve block relieved the pain.

Conclusion: Postsling neuralgia diagnosis using sensory mapping and a nerve stimulator aids in indentifying the nerve involved and in successful conservative treatment with a nerve block.

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Figures

Fig. 1
Fig. 1
A. Anterior cutaneous branches of the iliohypogastric nerve. B. Anterior labial branches of the ilioinguinal nerve. C. Genitofemoral nerve (both the genital and femoral braches). D. Dorsal nerve of the clitoris (continuation of pudendal nerve shown as dashed lines deeper in the muscles of the urogenital diaphragm). The course of the specified nerves is delineated based on quantitative sensory testing and selective nerve block in this patient.
See this image and copyright information in PMC

References

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