Two interesting cases of meralgia paraesthetica

Abstract

Meralgia paraesthetica (MP) is a condition originally described by Bernhardt in 1878 and was eventually named by Roth in 1895. It is caused by compression of the lateral femoral cutaneous nerve (LFCN) resulting in varying types of discomfort. Severity of the symptoms can range from mildly uncomfortable to painfully disabling. In this article we discuss 2 patients with a LFCN injury occurring as a result of laparoscopic ventral rectopexy (LVR). The first patient is a 46-year-old female who reported pain and dysesthesia in the left groin and the anterolateral thigh, 2 days post LCR. A conservative approach was taken and at the 6-month follow-up the symptoms had resolved. The second patient is a 51-year-old female who reported increased sensitivity to bed sheets over the anterolateral aspect of her left thigh, in the immediate post-operative period following LVR. She was similarly managed conservatively but her symptoms persisted. The LFCN arises from the dorsal branches of the second and third lumbar roots. It crosses the iliacus muscle deep to the fascia. Injury or entrapment to surrounding neural structures including the LFCN, commonly results following common laparoscopic procedures. In some cases, additional surgical intervention is required for successful management of the symptoms. In our patients, the MP syndrome was clearly related to the operation because symptoms appeared in the immediate post-operative period and were not present beforehand. LVR is a relatively new and evolving procedure with few reports of associated peri-operative complications.