Clinical findings in patients with femoral cutaneous sensory change after gynecologic operation

Seo, Min Jung; Han, Gyung An; Jung, Jee Wook; Lee, Sung Jae; Choi, Won Joon; Lee, Soon Ae; Lee, Jong Hak; Baek, Won Young

Abstract

OBJECTIVE
To evaluate the relationship between postoperative sensory change on lower extremities and clinical factors associated with gynecologic operation. METHODS: We retrospectively reviewed 38 cases of patients with postoperative complaints of pain or dysthesis on lower extremities, especially anterolateral thigh from March 1993 through December 1999 at Gyeongsang National University Hospital, Department of Obstetrics and Gynecology. The electromyography (EMG) and nerve conduction velocity (NCV) were performed in all 38 patients. According to the result of EMG and NCV, patients were divided into control group (n=28) which in that with normal finding in electrodiagnosis and study group (n=10) who showed femoral cutaneous nerve injury in electrodiagnosis. Clinical characteristics (age, height, weight and operative history), operative methods, skin incisional method, operative time and postoperative diagnosis were reviewed in each group. RESULTS: There were significant differences in patient's body weight, height, skin incisional method and operative method between control and study group. Height was 152.5cm [150.3-155.6] in study group and 157.5cm [153.4-159.2] in control group (p-value = 0.020). Weight was 46.9kg [43.4-58.0] in study group and 57.0kg [54.4-58.1] in control group (p-value=0.004). Skin incisional method in study group was done by 6 cases (60%) of infraumbilical mid-line vertical incision and in control group by 5 cases (17.9%) (p-value = 0.019). In operative method, radical hysterectomy was 4 cases (40%) in study group and 2 cases (7.1%) in control group (p-value=0.031). But no correlation was observed in post-operative diagnosis, operative time, blood loss and transfusion between two groups. CONCLUSION: It was suggested that Lateral femoral cutaneous nerve was compressed by pelvic retractor during the gynecologic operation. Patient's body weight, height, skin incisional method and operative method may play a role of compressive factor on Lateral femoral cutaneous nerve, increasing Meralgia Paresthetica.