The genitofemoral nerve descends through the psoas and provides the cremasteric reflex (stroking the inner thigh contracts the cremaster to elevate the testis) and upper thigh sensation. It is injured during retroperitoneal procedures (aortic surgery, kidney surgery, laparoscopic hernia repair), producing chronic groin and scrotal pain from neuroma formation. Genitofemoral neuralgia from mesh contact after hernia repair is a recognised complication.
| Origin | Lumbar plexus (L1, L2) |
|---|
Genitofemoral neuralgia after laparoscopic inguinal hernia repair (mesh tacking near the nerve) produces burning anterior thigh and scrotal pain reproduced by hip extension. Ultrasound-guided nerve block at the internal inguinal ring or psoas confirms diagnosis. Neurectomy (resection of the nerve) provides definitive relief for refractory cases.
Nerve compression from mesh tack producing anterior thigh and scrotal burning managed with nerve block and neurectomy.
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