Pilot randomized controlled study of preservation or division of ilioinguinal nerve in open mesh repair of inguinal hernia

Background: There is uncertainty as to whether preservation or elective div ision of the ilioinguinal nerve influences pain and sensory loss following inguinal hernia repair. Methods: In 20 men with primary bilateral inguinal hernias undergoing open tension-free mesh repair, the sides (right or left) were randomized for pre servation or division of the ilioinguinal nerve. Patients were reviewed on day 1, 4 weeks and 6 months after operation. Any pain or numbness, as well as any loss of sensation in the area supplied by the nerve, was recorded. Results: No significant difference was seen in pain or numbness between the divided and preserved sides. Sensory loss detected by clinical examination was more common following the division of the nerve compared with preserva tion. Conclusion: Within the limitations of a small sample size, elective divisio n of the ilioinguinal nerve during inguinal hernia repair does not appear t o be associated with a significant increase in postoperative symptoms.