The iliohypogastric nerve is the motor supply to the lower abdominal wall muscles and the sensory supply to the lower abdomen and lateral hip region. It is vulnerable during lower abdominal incisions (Pfannenstiel, McBurney, inguinal ligament-based incisions) and during iliac crest bone graft harvest. Iliohypogastric neuralgia from injury produces lower abdominal and suprapubic burning pain and skin hypersensitivity.
| Origin | Lumbar plexus (L1) alongside the ilioinguinal nerve |
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The iliohypogastric nerve is at risk during Pfannenstiel incisions (the standard incision for caesarean section and pelvic surgery) if the incision extends lateral to the lateral border of the rectus muscle. Entrapment by the closing suture in the external oblique aponeurosis produces a painful hypersensitive scar area. Nerve block or neurectomy provides relief.
Nerve injury during lower abdominal surgery producing suprapubic burning pain and hypersensitivity managed with nerve block or neurectomy.
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