FEMORAL NEUROPATHY AFTER VAGINAL HYSTERECTOMY - 2 CASE-REPORTS AND REVIEW OF THE LITERATURE

Femoral neuropathy is a known complication of abdominal hysterectomy b ut occurs uncommonly after vaginal hysterectomy. Two cases of this com plication after vaginal hysterectomy are described, with discussion of possible etiology, treatment, and preventive measures. Both patients had large thighs and were positioned with hyperflexion of the hips. Bo th procedures were prolonged. Unilateral and bilateral femoral neuropa thies were noted postoperatively. Treatment involved physical therapy, nonsteroidal anti-inflammatory medication, and mechanical support. Sp ontaneous recovery occurred in 29 and 40 days. Femoral neuropathy can occur after prolonged vaginal hysterectomy secondary to compression of the nerve at the level of the inguinal ligament. Obese women appear t o be more at risk. Prevention involves avoiding extremes of flexion, e xternal rotation, and abduction of the hips when positioning the patie nt and avoiding leaning on the patient's thighs. Treatment is supporti ve, with full recovery anticipated.