There are three nerves that provide sensation to the skin in the region of the pubic hair, scrotum or mons pubis, and the medial thigh. These nerves are the ilioinguinal nerve, the iliohypogastric nerve, and the genital nerve. Some athletes with a sports hernia will have symptoms related to one of these nerves. The commonly involved nerve is the ilioinguinal nerve. The athlete will report that there is an electrical or burning pain that radiates down the medial thigh or towards the scrotum or onto mons pubis. The diagnosis can be confirmed by direct pressure or tapping on the ilioinguinal nerve (Tinel sign). In addition, the athlete will have significant relief with an ilioinguinal nerve block. The nerve can sometimes be imaged with ultrasound or MRI. At the time of surgery, the nerve is examined. If there are adhesions around the nerve then these are lysed. If there has been a significant injury to the nerve, then a neurectomy should be performed. After a neurectomy, there is numbness of the skin. Most of the numbness resolves with time. A neurectomy does not affect sex.
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