Nerve Surgery to Treat Intractable Genitofemoral Neuropathic Pain following Laparoscopic Live Kidney Donation

To date live laparoscopic donor nephrectomies (LLDN) are frequently performed. The most common complications entail bleeding, wound infection, and incisional hernia. Here we discuss a 50-year-old patient with a severe less known complication, namely, postoperative persistent neuropathic pain in the...

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Main Authors: K. Ramdhani, M. J. A. Malessy, M. J. G. Simon, V. A. L. Huurman
Format: Article
Language:English
Published: Wiley 2018-01-01
Series:Case Reports in Transplantation
Online Access:http://dx.doi.org/10.1155/2018/9326975
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author K. Ramdhani
M. J. A. Malessy
M. J. G. Simon
V. A. L. Huurman
author_facet K. Ramdhani
M. J. A. Malessy
M. J. G. Simon
V. A. L. Huurman
author_sort K. Ramdhani
collection DOAJ
description To date live laparoscopic donor nephrectomies (LLDN) are frequently performed. The most common complications entail bleeding, wound infection, and incisional hernia. Here we discuss a 50-year-old patient with a severe less known complication, namely, postoperative persistent neuropathic pain in the scrotum and left upper leg. Satisfactory pain control could not be obtained in 3 years of postoperative pain treatment which consisted of neuroleptic drugs, blocks of the L1/L2 dorsal roots with local anaesthetics, and pulsed radiofrequency lesioning. Exploratory laparoscopy was performed to assess the aspect of the genitofemoral nerve (GFN). A hemoclip used for the closure of the ureter at the time of nephrectomy was found in close relation to the GFN. The clip was removed and the GFN was subsequently cut proximal to the side of this clip. Soon after surgery the patient was completely pain-free and could return to his normal activities. Surgery should be considered in case of GFN neuropathic pain following LLDN.
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series Case Reports in Transplantation
spelling doaj-art-f5338d2fba67422a9dd8f141323ea55c2025-02-03T01:07:09ZengWileyCase Reports in Transplantation2090-69432090-69512018-01-01201810.1155/2018/93269759326975Nerve Surgery to Treat Intractable Genitofemoral Neuropathic Pain following Laparoscopic Live Kidney DonationK. Ramdhani0M. J. A. Malessy1M. J. G. Simon2V. A. L. Huurman3Department of Transplant Surgery, Leiden University Medical Center, Leiden, NetherlandsDepartment of Neurosurgery, Leiden University Medical Center, Leiden, NetherlandsDepartment of Anesthesiology, Leiden University Medical Center, Leiden, NetherlandsDepartment of Transplant Surgery, Leiden University Medical Center, Leiden, NetherlandsTo date live laparoscopic donor nephrectomies (LLDN) are frequently performed. The most common complications entail bleeding, wound infection, and incisional hernia. Here we discuss a 50-year-old patient with a severe less known complication, namely, postoperative persistent neuropathic pain in the scrotum and left upper leg. Satisfactory pain control could not be obtained in 3 years of postoperative pain treatment which consisted of neuroleptic drugs, blocks of the L1/L2 dorsal roots with local anaesthetics, and pulsed radiofrequency lesioning. Exploratory laparoscopy was performed to assess the aspect of the genitofemoral nerve (GFN). A hemoclip used for the closure of the ureter at the time of nephrectomy was found in close relation to the GFN. The clip was removed and the GFN was subsequently cut proximal to the side of this clip. Soon after surgery the patient was completely pain-free and could return to his normal activities. Surgery should be considered in case of GFN neuropathic pain following LLDN.http://dx.doi.org/10.1155/2018/9326975
spellingShingle K. Ramdhani
M. J. A. Malessy
M. J. G. Simon
V. A. L. Huurman
Nerve Surgery to Treat Intractable Genitofemoral Neuropathic Pain following Laparoscopic Live Kidney Donation
Case Reports in Transplantation
title Nerve Surgery to Treat Intractable Genitofemoral Neuropathic Pain following Laparoscopic Live Kidney Donation
title_full Nerve Surgery to Treat Intractable Genitofemoral Neuropathic Pain following Laparoscopic Live Kidney Donation
title_fullStr Nerve Surgery to Treat Intractable Genitofemoral Neuropathic Pain following Laparoscopic Live Kidney Donation
title_full_unstemmed Nerve Surgery to Treat Intractable Genitofemoral Neuropathic Pain following Laparoscopic Live Kidney Donation
title_short Nerve Surgery to Treat Intractable Genitofemoral Neuropathic Pain following Laparoscopic Live Kidney Donation
title_sort nerve surgery to treat intractable genitofemoral neuropathic pain following laparoscopic live kidney donation
url http://dx.doi.org/10.1155/2018/9326975
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