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Obstetrics & Gynecology 2006;108:27-31
© 2006 by The American College of Obstetricians and Gynecologists
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ORIGINAL RESEARCH

Algorithm for Treatment of Postoperative Incisional Groin Pain After Cesarean Delivery or Hysterectomy

Ivica Ducic, MD, PhD1, Michael Moxley, MD2 and Ali Al-Attar, MD, PhD1

From the 1Department of Plastic Surgery and the 2Department of Obstetrics and Gynecology, Georgetown University Hospital, Washington, DC.

OBJECTIVE: Despite the low mortality and morbidity of major obstetric and gynecologic surgeries (including hysterectomy and cesarean delivery), women undergoing these procedures occasionally suffer from intractable postoperative suprapubic and groin pain. We present seven patients whose intractable pain lasted longer than 6 months and was not due to gynecologic disease or other obvious pathology.

METHODS: Neuromas of the ilioinguinal, iliohypogastric, and/or genitofemoral nerves were suspected clinically and confirmed intraoperatively.

RESULTS: After neuroma resection, all patients reported complete and durable pain relief.

CONCLUSION: Intractable pain after obstetric or gynecologic surgery can be due to neuroma formation, and resection is therapeutic. We suggest an algorithm for the management of women with chronic intractable suprapubic or groin pain after major obstetric and gynecologic surgery.

LEVEL OF EVIDENCE: II-3




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 Obstet GynecolHome page
M. J. Loos, M. R. Scheltinga, L. G. Mulders, and R. M. Roumen
The Pfannenstiel Incision as a Source of Chronic Pain
Obstet. Gynecol., April 1, 2008; 111(4): 839 - 846.
[Abstract] [Full Text] [PDF]


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