Primary Groin Pain
Musculoskeletal anatomy of groin pain
Neuroanatomy of groin pain
History: High yield questions to the patient as part of the history/intake
Physical Examination: Highly sensitive and specific exam findings
Inguinal Hernia, Femoral Hernia
Non-Hernia Causes: Adductor Tendinitis, Osteitis Pubis, Epididymitis, Varicocele, Referred Pain (from hip (e.g., labral tear), back (e.g., radiculopathy, sacroiliitis, ankylosing spondylitis))
Sports Hernia
Chronic pelvic pain in women (endometriosis, pelvic floor dysfunction, round ligament syndrome or masses, ovarian cyst disease, occult hernias)
Occult Hernias: Typical presentation, symptoms, exam findings, radiologic evaluation
Secondary Groin Pain
Causes of Pain from Anterior Repair
Causes of Pain from Posterior Repair
Algorithm for Pain Management
Pharmacologic Management
Interventional Procedures: Nerve block, epidurals, ablation, neurostimulators
Radiologic findings of mesh and meshoma
Dermatomal Mapping: Pre/post-operative assessment
Quantitative Sensory Testing (QST)
Management of Recurrence
Open Triple Neurectomy vs selective neurectomy
Laparoscopic Triple Neurectomy
Meshoma Removal (Lap and open)
Treatment of Orchialgia
Selected Topics
Prevention of Pain: Open Technique (include mesh-specific tips)
Prevention of Pain: Laparoscopic Technique (include technical tips)
Prophylactic Neurectomy versus Pragmatic Neurectomy
Selective Neurectomy versus Triple Neurectomy
Patient Narratives
Emerging patient and provider care communities (social media for patients with groin pain and for providers who care for patients with groin pain)
Value-based clinical quality improvement- learning to improve the value of treating patients with groin pain
Team based approach for treating patients with chronic groin pain.