Brian P. Jacob, David C. Chen, Bruce Ramshaw, Shirin Towfigh (eds.) - The SAGES Manual of Groin Pain-Springer International Publishing (2016)

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286 R. Álvarez Subsequently, we must determine the specific source of pain. That is, to establish which nerve or multiple nerve trunks are involved, and at the same time determine if the source of pain is non-neuropathic (meshomas, orchialgia, pubalgia, or vague) or some other mechanism when the nerve trunks are clearly preserved. Finally, it is imperative to have a record of how the intensity of pain is perceived by the patient. For this purpose, the visual analogue scale (VAS) is used in conjunction with this classification system. We reported the original Dermatome Mapping Classification in 2009 [ 9 ]; the updated 2015 DMC is presented in (Fig. 21.12 ) with respect to the Location Type Source R Right L Left C Central N Neuropathic 1 Ilio inguinal Nerve 2 Ilio hypogastric Nerve 3 Genital Branch 4 Femoral Branch 5 Lateral F Cutaneous Nerve T1-T12 Costal Nerves Intensity VAS I - X I - X I - X I - X I - X I - X NN Non Neuropathic G Granuloma H Hernia L Lipoma M Meshoma O Orchialgia P Pubalgia S Sports Hernia V Vague I - X I - X I - X I - X I - X I - X I - X I - X D Denervation Discomfort 1 Ilio inguinal Nerve 2 Ilio hypogastric Nerve 3 Genital Branch 4 Femoral Branch 5 Lateral F Cutaneous Nerve T1-T12 Costal Nerves I - X I - X I - X I - X I - X I - X Fig. 21.12. DMC (Dermatome Mapping Classification). Dermatome Mapping Classification (DMC) is classified evaluating 4 aspects in chronic postoperative pain: location, type, source, and intensity (updated version of the 1999 original [ 9 ]).
21. Dermatome Mapping: Preoperative and Postoperative Assessment 287 pre- and postoperative evaluations of patients with chronic postoperative pain. Currently, we are updating the DMC regularly, expanding it, for example, not only to evaluate the inguinal region but also to consider thoracic nerves for cases when postoperative pain occurs in the abdominal region due to injury or entrapment of thoracic nerves during an inguinal laparoscopic surgery, or when using transfascial sutures, for instance, in the Rives or laparoscopic techniques. We have also modified the DMC to include Dr Chen’s contribution of the term “vague” for nonspecific situations, subjective inconsistencies, or patients simulating pain that had previously been termed “faking.” The Dermatome Mapping Test (DMT) results are presented and sorted according to the author’s classification (DMC), which takes into account 4 main aspects: 1. Pain location L : Pain or discomfort is located on the left side R : Pain or discomfort is located on the right side C : Pain or discomfort is located on the center 2. Type of pain or denervation discomfort N : Neuropathic pain that follows the path of a nerve branch or dermatome NN : Non-neuropathic pain that does not follow the pattern of a nerve branch or dermatome D : Denervation incidental or secondary to neurectomy, manifested by anesthesia, hypoesthesia, or numbness 3. Source of neuropathic pain or discomfort and denervation symptoms Source of neuropathic pain or denervation symptoms 1. For the dermatome of the ilioinguinal nerve 2. For dermatome of the iliohypogastric nerve 3. For the dermatome of the genital branch 4. For the dermatome of the femoral branch 5. For the dermatome of the lateral femoral cutaneous nerve T1 through T12 For each thoracic nerve dermatome Source of non-neuropathic pain Those symptoms that do not follow a nerve dermatome pattern. The following nomenclature for the source of pain or discomfort is assigned
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Brian P. Jacob · David C. Chen Bru
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The SAGES Manual of Groin Pain Bria
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Foreword Inguinal hernia repair is
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Contents Part I Primary Groin Pain
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Contents ix 22 Management of Inguin
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Contents xi 45 Value-Based Clinical
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xiv Editors and Contributors Jeffre
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xvi Editors and Contributors David
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xviii Editors and Contributors Greg
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xx Editors and Contributors David S
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1. Introduction to Primary and Seco
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10 I.A. Gawlas and W.J. Peacock Ili
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12 I.A. Gawlas and W.J. Peacock Tra
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14 I.A. Gawlas and W.J. Peacock Var
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3. Complex Regional Pain Syndrome T
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4. Chief Complaint of Groin Pain: H
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4. Chief Complaint of Groin Pain…
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42 C. Ma and A. Ramaswamy inguinal
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44 C. Ma and A. Ramaswamy Categoriz
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46 C. Ma and A. Ramaswamy with no s
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48 C. Ma and A. Ramaswamy 26. Aasva
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50 I.M. Daoud and K. Dunn Other per
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52 I.M. Daoud and K. Dunn low herni
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54 I.M. Daoud and K. Dunn In the po
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56 I.M. Daoud and K. Dunn with a he
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58 I.M. Daoud and K. Dunn 13. O’C
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60 G.J. Mancini Occult Hernia Backg
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62 G.J. Mancini Magnetic resonance
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64 G.J. Mancini rocking motion can
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66 G.J. Mancini Unique to the adduc
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68 G.J. Mancini two nerve injuries
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70 G.J. Mancini abdominis has a rep
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72 G.J. Mancini 5. Light D, Ratnasi
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74 J.C. Campbell and G.D. Paiement
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9. Groin Pain Etiology: Spine and B
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10. Groin Pain Etiology: Spermatic
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Table 10.2. European Association of
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138 M. Hibner and C. Coyne Piriform
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140 M. Hibner and C. Coyne Fig. 11.
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142 M. Hibner and C. Coyne Table 11
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144 M. Hibner and C. Coyne present
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146 M. Hibner and C. Coyne Table 11
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148 M. Hibner and C. Coyne Once the
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150 M. Hibner and C. Coyne 3. Hibne
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12. Chronic Pelvic Pain in Women M.
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12. Chronic Pelvic Pain in Women 15
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174 J.M. Miller et al. Knowing the
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176 J.M. Miller et al. Fig. 13.2. A
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182 J.M. Miller et al. Fig. 13.9. C
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184 J.M. Miller et al. Fig. 13.14.
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192 J.M. Miller et al. Cardiac Cath
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194 B.J. Dunkin Noxious peripheral
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196 B.J. Dunkin Table 14.1. Summary
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198 B.J. Dunkin Rectus abdominis Ex
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200 B.J. Dunkin COX-1 COX-2 Celecpx
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202 B.J. Dunkin Table 14.2. Common
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204 B.J. Dunkin Possible Preoperati
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206 B.J. Dunkin Postoperative Pain
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208 B.J. Dunkin Summary Understandi
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15. Chronic Groin Pain Following An
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222 E.L. Felix not seem to alter th
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224 E.L. Felix nerves from the surg
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226 E.L. Felix Fig. 16.2. Lateral f
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228 E.L. Felix It has been establis
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230 E.L. Felix 18. Pollak R, Nyhus
Page 244 and 245: 17. The Orthopedic Perspective on G
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25. Laparoscopic Triple Neurectomy
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25. Laparoscopic Triple Neurectomy
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26. Chronic Orchialgia: Workup and
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27. The Role of Bioactive Prostheti
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376 G. Campanelli et al. affecting
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378 G. Campanelli et al. into the w
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380 G. Campanelli et al. chronic gr
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382 G. Campanelli et al. A prospect
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384 G. Campanelli et al. open mesh
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386 G. Campanelli et al. 38. Alfier
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29. Prevention of Pain: Optimizing
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30. Prophylactic Neurectomy Versus
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Table 31.1. Selective neurectomy wi
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408 W.M.J. Reinpold and A.D. Schroe
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32. Chronic Groin Pain: Mesh or No
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Part IV Case Reports and Patients
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430 S. Towfigh were irregular and s
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432 S. Towfigh in addressing her sy
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434 S. Towfigh Conclusion We have y
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436 K.W. Kercher Physical Examinati
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438 K.W. Kercher Fig. 34.4. Left ad
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440 K.W. Kercher Fig. 34.5. After d
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442 K.W. Kercher the posterior wall
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444 K.W. Kercher Table 34.2. Surgic
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35. Chronic Post-inguinal Herniorrh
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35 Chronic Post-inguinal Herniorrha
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35 Chronic Post-inguinal Herniorrha
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36. Sports Hernia with Adductor Ten
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464 C.G. DuCoin and G.R. Jacobsen P
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466 C.G. DuCoin and G.R. Jacobsen O
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468 J.A. Blatnik and A.S. Prabhu a
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470 J.A. Blatnik and A.S. Prabhu Fi
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472 J.A. Blatnik and A.S. Prabhu ma
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474 S. Towfigh Physical Exam The pa
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476 S. Towfigh The patient’s loca
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478 S. Towfigh Fig. 39.2. Diagram o
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480 S. Towfigh periphery. He is 2+
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482 S. Towfigh References 1. Matthi
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484 N.A. Al-Enazi and B.P. Jacob
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486 N.A. Al-Enazi and B.P. Jacob Fi
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488 N.A. Al-Enazi and B.P. Jacob pu
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42. Patient with Chronic Pelvic Pai
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42. Patient with Chronic Pelvic Pai
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43. Thoracolumbar Syndrome James A.
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43. Thoracolumbar Syndrome 497 The
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43. Thoracolumbar Syndrome 499 Groi
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44. Patient with Referred Hip Pain
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44. Patient with Referred Hip Pain
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45. Value-Based Clinical Quality Im
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46. Patient Care Manager Perspectiv
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47. Workers’ Compensation: An Occ
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532 Index Athletic pubalgia (cont.)
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534 Index Chronic post-herniorrhaph
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536 Index Groin pain (cont.) magnet
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538 Index Ilioinguinal nerve (IIN)
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540 Index Local anesthetics (cont.)
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542 Index Peripheral nerve entrapme
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544 Index S Sacroiliac (SI) joint d
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546 Index Transperineal pudendal ne
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Brian P. Jacob, David C. Chen, Bruce Ramshaw, Shirin Towfigh (eds.) - The SAGES Manual of Groin Pain-Springer International Publishing (2016)

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