Case Report

Novel Non-invasive Management of Chronic Groin Pain from Fibrosed Contracted Inguinal Ligament

A Lokeshwar Raaju and N Ragunanthan*

Published: 12 October, 2018 | Volume 2 - Issue 1 | Pages: 001-003

A 34-year-old male patient presented with the complaint of chronic pain in the left groin following left side testicular vein ligation for varicocele. Ilio-inguinal neurectomy and cremaster muscle division was done in another hospital for the pain but with no relief of pain. Patient on examination showed point tenderness in the left groin at the pubic tubercle. Finger Invagination test in the left was painful with severe tenderness. Investigation showed fibrosed contracted left distal inguinal ligament. Percutaneous Ultrasonographic (USG) guided inguinal ligament release and Platelet-Rich Plasma (PRP) injection relieved the pain completely. Post-procedure patient showed significant improvement of pain.

Read Full Article HTML DOI: 10.29328/journal.aceo.1001003 Cite this Article Read Full Article PDF


Chronic groin pain; Inguinal ligament fibrosis; Percutaneous needle release; Platelet-rich plasma injection


  1. Kasper D, Fauci A, Hauser S, Longo D, Jameson JL, et al. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015. Ref.: https://goo.gl/LqYySB
  2. Heise CP, Starling JR. Mesh inguinodynia: a new clinical syndrome after inguinal herniorrhaphy? J Am Coll Surg. 1998; 187: 514-518. Ref.: https://goo.gl/eXoqnc
  3. Kumar S, Wilson RG, Nixon SJ, Macintyre IM. Chronic pain after laparoscopic and open mesh repair of groin hernia. Br J Surg. 2002; 89: 1476-1479. Ref.: https://goo.gl/h4bm2Z
  4. Ashby EC. Chronic obscure groin pain is commonly caused by enthesopathy: 'tennis elbow' of the groin. Br J Surg. 1994; 81: 1632-1634. Ref.: https://goo.gl/2WqZgd
  5. Maarten JA. Surgical management of chronic inguinal pain syndromes. (University of Maastricht, September 29th 2011). Ref.: https://goo.gl/hKHRNx
  6. Keller JE, Stefanidis D, Dolce CJ, Iannitti DA, Kercher KW, et al. Combined open and laparoscopic approach to chronic pain after inguinal hernia repair. Am Surg. 2008; 74: 695-700. Ref.: https://goo.gl/Z9iP7a
  7. Zwaans WA, Perquin CW, Loos MJ, Roumen RM, Scheltinga MR. Mesh Removal and Selective Neurectomy for Persistent Groin Pain Following Lichtenstein Repair. World J Surg. 2017; 41: 701-712. Ref.: https://goo.gl/Q7EnW9
  8. BD Chaurasia’s Textbook of Human Anatomy. Vol-2, Fifth Edition. 223-226.
  9. Lloyd DM, Sutton CD, Altafa A, Fareed K, Bloxham L, et al. Laparoscopic inguinal ligament tenotomy and mesh reinforcement of the anterior abdominal wall: a new approach for the management of chronic groin pain. Surg Laparosc Endosc Percutan Tech. 2008; 18: 63-68. Ref.: https://goo.gl/8wmF9i
  10. Mui WL, Ng CS, Fung TM, Cheung FK, Wong CM, et al. Prophylactic ilioinguinal neurectomy in open inguinal hernia repair: a double-blind randomized controlled trial. Ann Surg. 2006; 244: 27-33. Ref.: https://goo.gl/kWxSsx
  11. Boswell SG, Cole BJ, Sundman EA, Karas V, Fortier LA. Platelet-rich plasma: a milieu of bioactive factors. Arthroscopy. 2012; 28: 429-439. Ref.: https://goo.gl/BCtYCd


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