Nerve Distribution Question

[KC17]

Hi Everyone,

I don't know if you read a previous post of mine stating that my mother was to have a Lap Assisted Hysterectomy, but since that post she has and is about two weeks post-op.

Almost immediately after waking she has had severe burning pain in the lower abdomen, on the right side of her pubic bone area, and midway down her inner right thigh. Her clothes hurt to even touch her in these areas, yet she can push on her incisions with no problem. It definitely sounds like a nerve issue to me.

What I'm hoping is that somebody, anybody on this board can give me some insight as to what nerve or nerves might be responsible for this distribution.

Thank You,
Krista

[Faith]

I didn't spend time researching this, but my first thought would be obturator nerve. I know the oburator nerve runs down the inner thigh. Not sure if it would also cause pubic bone area pain.

[nyt]

She could have more than one nerve involved. The mons pubis,(top of the pubic bone), is innervated by the ilioinguinal and/or genitofemoral nerve. There are four anatomical variations of these two nerves, sometimes they overlap and some times they have their own separate areas. Dr. Dellon has published the anatomically variations of these two nerves. Potentially she could have obturator nerve contributing to the inner part of the leg but that injury is very rare during LAV, the ilioinguinal and genitofemoral are the more likely candidates. It is not unusual if the ilioinguinal nerve has been damage by the trocar that the iliohypogastric and genitofemoral were injured at the same time. These three nerves tend to be damaged in a group from trocar placements. In the past if medication did not settle the nerve down and get the patient comfortable physicians would cut all three nerves because it was quite complicated and difficult to figure out which nerve it was. Now with guided nerve blocks physicians can pinpoint which nerve is exactly the culprit and like I said do not be surprised if there is more than one. The attached picture should be helpful.

She should talk with the dr. about starting on medication to get the nerve to settle down and get her more comfortable. If she does not get comfortable with medication within whatever she feels and determines with the physician is a reasonable time frame then surgery or cryoablation are options. Many pain doctors do the cryoablations but make sure it is someone good. For surgery, Dr. Dellon is excellent but does not take insurance so expensive. Dr. Ducic trained with Dr. Dellon and has a great reputation and does take insurance. Dr. Conway can do the ilioinguinal surgery, I don't know if she needed genitofemoral if he does that surgery. Dr. Howard can do both the ilioinguinal and genitofemoral. There is a previous thread regarding pros and cons of cryoablation versus neurectomy of these nerves if she ever gets to that point.

She might want to try some ice on the area to see if that helps at all.

Good luck and your mom is in my thoughts as prayers as this happened to me after my hysterectomy and it is no fun!

Nerves of pelvis and legs ventral view.pdf

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[Karyn]

Hi Krista,
I'm so very sorry to hear about your Mom! I hope she finds out what's going on quickly and doesn't have to suffer for a long period of time. She's very luck to have you on her side and of course we'll do whatever we can to help!
Hugs,
Karyn

[Celeste]

Almost immediately after waking she has had severe burning pain in the lower abdomen, on the right side of her pubic bone area, and midway down her inner right thigh. Her clothes hurt to even touch her in these areas, yet she can push on her incisions with no problem. It definitely sounds like a nerve issue to me.

I'm so sorry, Krista. I know that was your worst nightmare, that she would get a nerve problem from the surgery after what you had learned here. I know that a lot of things resolve on their own post op, and I'm going to hope that this does.

[Torbjorn]

hi Celeste, could you tell me what your symptoms were before the Housto Team operated on you. Tks Helen