A young male patient developed chronic, severe, and disabling right sided groin
pain following resection of his left
testicular cancer. Since there is considerable overlap, ultrasound guided, selective diagnostic
nerve blocks were done for ilioinguinal, iliohypogastric, and genitofemoral nerves, to determine the involved nerve territory. It was revealed that genitofemoral
neuralgia was the likely cause. As a therapeutic procedure, it was injected with
local anesthetic and
steroid using ultrasound guidance. The initial injection led to
pain relief of 3 months. Subsequent blocks reinforced the existing
analgesia and were sufficient to allow for maintenance with the use of
analgesic medications. This case report describes the successful use of diagnostic selective
nerve blocks for the assessment of groin
pain, subsequent to which an ultrasound guided therapeutic injection of genitofemoral nerve led to long term
pain relief. As a therapeutic procedure, genitofemoral
nerve block is done in patients with genitofemoral
neuralgia. Ultrasound allows for controlled administration and greatly enhances the technical ability to perform precise localization and injection. There are very few case reports of such a treatment in the published literature. Apart from the case report, we also highlight the relevant anatomy and a brief review of genitofemoral
neuralgia and its treatment.