[KevW]

Dr. Brown,

Thank you for your post.

I’ve really busy with work and I haven’t yet had time yet to watch the HerniaTalk that Dr. Towfigh recommended, so these questions may be addressed there. But regarding the ilioinguinal nerve, it being a sensory nerve doesn’t cause issues with numbness that can lead to impotence? I keep coming across stories of men losing all sensation in their genitals after inguinal hernia repair, and I’ve been assuming that this was due to sensory nerve damage. I realize that not every member here is an expert, necessarily, but a member in another thread said this

While the ilioinguinal and the genital branch of genitofemoral nerves do not directly innervate the penis. Both branches as they run distally near the base/root of penis and scrotum indirectly serve a sexual function by allowing proper support of an erection and retraction of scrotum. When the groin muscle of the base of your penis is numb from ilioinguinal being resected; denervated, you can’t hold up an erection upright strong like you would normally) and there will also be scrotal pain.

What are your thoughts on this? Is there any truth to the above statement? I keep coming across statements of this kind, and its hard for me to reconcile them with others stating that the sensory nerves at risk in hernia surgery don’t impact sexual function.

[KevW]

Dr. Towfigh,

Thank you so much for your response. Last year I had a consultation with a surgeon who specializes in the Desarda technique, and I was told that the ilioinguinal nerve plays an important role in getting and maintaining an erection, so I hope you can understand my confusion. My conceptions aren’t just coming from reading on my own. I’m hearing doctors say seemingly different things. I say “seemingly” because I realize there may be misunderstandings on my end. This doctor explained to me that, because its a sensory nerve, damage to the ilioinguinal nerve has been known to result in numbness in the groin that can make it difficult to perform sexually, and he warned me that this could happen if the nerve becomes entrapped in a mesh implant or scar tissue. What are your thoughts on this? I’ve come across stories of patients experiencing numbness after the surgery and have lost the ability to become aroused. I’m not sure what to make of these stories now but I’ve been assuming that this was due to the damage of sensory nerves.

After reading your response, I’ve decided to cross Kugel repair and any open-surgery with mesh off my list. So I guess the question for me now becomes one of open surgery without mesh vs. laparoscopic with mesh. Which would you say is the less riskier surgery if I’m concerned with nerve damage? What are your thoughts on Desarda, Kang, and Shouldice? How do these stand up against laparoscopic mesh surgery in terms of chronic pain and nerve damage? The Desarda specialist I spoke with warned me against Shouldice, saying that it’s even worse than mesh in terms of scar tissue that can aggravate the nerves.

Again, I want to thank you for your response and helping to clear up some of my confusion. And I will definitely watch the HerniaTalk session with Dr. Turek.

• This reply was modified 3 years, 3 months ago by  KevW.