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 division 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 preservation 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 preservation. Conclusion: Within the limitations of a small sample size, elective division of the ilioinguinal nerve during inguinal hernia repair does not appear to be associated with a significant increase in postoperative symptoms.