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Can Abdominal Surgery Cause Chronic Pelvic Nerve Pain?

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Updated June 18, 2014

Question: Can Abdominal Surgery Cause Chronic Pelvic Nerve Pain?
Answer: Unfortunately, abdominal surgery can be the culprit of chronic pelvic nerve pain. For people whose pelvic nerves have been cut, stretched or otherwise damaged during abdominal surgery, such as an appendectomy or some types of hernia repair, the condition can be very disabling.

Abdominal surgery has been known, in some cases, to cause damage to the ilio-inguinal nerve, the ilio-hypogastric nerve and the genitofemoral nerve, all of which can lead to pelvic nerve pain. Here are a few reasons which this might happen.

  • Pelvic nerves are close to incisional sites. During routine abdominal and pelvic surgeries, the ilio-hypogastric and ilio-inguinal nerves are often directly in the line of fire. Due to anatomical differences between people, even the most skilled surgeons have the potential to sever these nerves.
  • Anatomically, pelvic nerves are different in each person. Pelvic nerve structure can vary greatly from person to person. In some people, the nerves sit under the abdominal muscles. In other people, they may pass right through them. Some people have more pelvic nerve branches than others. Avoiding pelvic nerve damage during surgery is not easy when there are so many potential variations.
  • Stretching pelvic nerves can also cause damage. You don’t have to have your pelvic nerves cut or nicked in order to suffer from chronic pelvic nerve pain: sometimes, the nerves are stretched enough during surgery that enough damage is done.
  • Pelvic nerves may become compressed after surgery. Nerve entrapment can also lead to pelvic nerve pain, and can occur in the pelvic nerves after some types of surgery.

Before you panic about having abdominal surgery, you should know that pelvic nerve pain caused by damage to the pelvic nerves is pretty rare. As more and more research becomes available, surgeons are using more advances techniques to avoid damage to pelvic nerves during abdominal and pelvic surgeries.

Sources:

Cardosi Richard J, Cox Carol S and Hoffman Mitchel S. Postoperative Neuropathies After Major Pelvic Surgery. Obstetrics & Gynecology. August 2002. 100:2. pp 240-244

Mitra R, Zeighami A, Mackey S. Pulsed Radiofrequency for the Treatment of Chronic Ilioinguinal Neuropathy. Hernia. 2007 Aug;11(4):369-71

National Pain Foundation. Pelvic Pain: Causes. Accessed 8/21/09. http://www.nationalpainfoundation.org/articles/717/causes

Ndiaye A, Diop M, Ndoye JM et al. Anatomical Basis of Neuropathies and Damage to the Ilioinguinal Nerve During Repairs of Groin Hernias. Surgical and Radiologic Anatomy. 29:8, December 2007.

Whiteside James L, Barber Matthew D, Walters Mark D, Falcone Tommaso. Anatomy of Ilioinguinal and Iliohypogastric Nerves in Relation to Trocar Placement and Low Transverse Incisions. American Journal of Obstetrics & Gynecology. December 2003. 189:6, Pages 1574-1578.

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