II. Pathophysiology

  1. Compression Neuropathy of ilioinguinal nerve
  2. Ilioinguinal nerve course
    1. Abdominal musculature (often site of compression)
    2. Inguinal Canal
    3. Superficial Inguinal Ring

III. Causes

  1. Post-surgical
    1. Appendectomy
    2. Inguinal Herniorrhaphy
  2. Athletes
    1. Direct Trauma
    2. Excessive abdominal muscle training

IV. Symptoms

  1. Paresthesias or numbness over nerve course
  2. Ilioinguinal nerve distribution
    1. Upper medial thigh
    2. Base of penis and Scrotum in men
    3. Labia majora and mons pubis in women

V. Signs

  1. Tinel's sign
    1. Tap over inguinal nerve in Inguinal Canal
  2. Local anesthetic injection
    1. Injected at site of inguinal nerve entrapment
    2. Diagnosis confirmed by relief of discomfort

VI. Management

  1. Local Corticosteroid Injection at entrapment site
  2. Surgical neurolysis in refractory cases

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