M44 with persisting right-sided groin pain after laparoscopic repair of right inguinal hernia 2.5 months ago. The surgeon thought the clinical features were those of neuralgia but wanted MRI to evaluate the mesh and rule out hernia recurrence.
Injury or entrapment of the genital branch of genitofemoral nerve associated with laparoscopic inguinal hernia repair.
Axial PD-weighted and fat-suppressed PD-weighted MR images are shown at the level of mid-inguinal canal. These demonstrate a diffusely hyperintense right cremaster muscle (arrowed). This is presumed to reflect acute denervation, i.e. objective evidence for either injury or entrapment of the genital branch of genitofemoral nerve.