Ultrasound-guided microwave ablation in the treatment of inguinal neuralgia

Steven P. Daniels, Helen S. Xu, Amgad Hanna, Jacob A. Greenberg, Kenneth S. Lee

Research output: Contribution to journalReview articlepeer-review

1 Scopus citations

Abstract

Chronic groin pain can be due to a variety of causes and is the most common complication of inguinal hernia repair surgery. The etiology of pain after inguinal hernia repair surgery is often multifactorial though injury to or scarring around the nerves in the operative region, namely the ilioinguinal nerve, genital branch of the genitofemoral nerve, and the iliohypogastric nerve, is thought to be a key factor in causing chronic post-operative hernia pain or inguinal neuralgia. Inguinal neuralgia is difficult to treat and requires a multidisciplinary approach. Radiologists play a key role in the management of these patients by providing accurate image-guided injections to alleviate patient symptoms and identify the pain generator. Recently, ultrasound-guided microwave ablation has emerged as a safe technique, capable of providing durable pain relief in the majority of patients with this difficult to treat condition. The objectives of this paper are to review the complex nerve anatomy of the groin, discuss diagnostic ultrasound-guided nerve injection and patient selection for nerve ablation, and illustrate the microwave ablation technique used at our institution.

Original languageEnglish (US)
Pages (from-to)475-483
Number of pages9
JournalSkeletal Radiology
Volume50
Issue number3
DOIs
StatePublished - Mar 2021
Externally publishedYes

Keywords

  • Chronic post-operative hernia pain
  • Genitofemoral nerve
  • Iliohypogastric nerve
  • Ilioinguinal nerve
  • Image-guided injection
  • Inguinal hernia
  • Inguinal neuralgia
  • Microwave ablation

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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