Unfortunately, approximately 3% of patients who undergo inguinal hernia repair will experience chronic pain at the repair site. This is thought to occur due to damage caused to the sensory nerves in this area by the surgery, or by the body's scarring after surgery. If there is no evidence of hernia recurrence, then the initial treatment is usually a trial of anti-inflammatory medications (such as ibuprofen or naproxen), with or without low-dose antidepressant medication (used for chronic pain syndrome, and not for depression). If this treatment does not alleviate the pain, then I sometimes will inject a steroid and anesthetic solution into the scar. This often provides long-lasting (and occasionally permanent) relief. In cases where such injections provide significant relief, but the pain recurs, it may be necessary for a surgeon to go back in and intentionally cut the three nerves that are the likely cause of this pain (this usually results in numbness of the groin and upper thigh areas (but not numbness of the penis or clitoris, thankfully).
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