This case involved a middle-aged male patient with bilateral inguinal hernias. The right side had both direct and indirect hernia, so the defendant repaired it with pre-cut mesh. The left side had smaller direct and indirect hernias, as well as an incarceration of a loop of the sigmoid. The defendant released the sigmoid colon and then used pre-cut mesh to repair this defect as well. Several weeks postoperatively, the patient began to complain of left groin burning and post-ejaculation testicular pain. His complaints varied over the next weeks, but then localized to pain in the right groin. The patient saw multiple doctors but his physical exams and multiple tests were essentially normal. His discomfort and minor urinary issues persisted and remained unrelieved by medications and trigger point injections.
About 15 months after the original surgery, the patient underwent a left inguinal hernia repair and division of the ilioinguinal nerve. During that procedure, adhesions were lysed and the ilioinguinal nerve was found to be adherent to the underside of the external oblique aponeurosis. The nerve was isolated and ligated proximally and distally to the entrapment. The hernia was repaired, the sigmoid was released, and the tissues were closed. The pathology was consistent with neuroma and the patient experienced relief of pain after the procedure for about 8 weeks.