Question:medium
Injury to which nerve during a herniorrhaphy may cause paresthesia at the root of the scrotum and base of the penis?
Injury to which nerve during a herniorrhaphy may cause paresthesia at the root of the scrotum and base of the penis?
Show Hint
This nerve runs in the inguinal canal itself and exits through the superficial ring, right in the surgical field of a hernia repair.
Updated On: Jul 8, 2026
- Ilioinguinal
- Pudendal
- Genitofemoral
- Iliohypogastric
Show Solution
The Correct Option is A
Solution and Explanation
Step 1: Picture the operative field of a hernia repair.
Inguinal hernia surgery works directly on the inguinal canal, where the spermatic cord and a nearby sensory nerve both run close to the sutures and mesh used to repair the defect.
Step 2: Identify the nerve that sits in this exact path.
The ilioinguinal nerve travels through this same canal and comes out at the superficial inguinal ring, making it one of the nerves most often caught, stretched, or trapped in scar tissue during the operation.
Step 3: Connect the nerve to its sensory territory.
It supplies the skin at the root of the penis and upper scrotum, so when it is injured, the patient feels numbness or tingling exactly in that region, matching the symptom in the question.
Step 4: Rule out nerves with a different territory or path.
The pudendal nerve reaches the genitals by a deeper perineal route, away from the hernia field. The genitofemoral nerve's genital branch mainly drives the cremaster muscle rather than skin sensation at this site. The iliohypogastric nerve covers the suprapubic skin, higher up than the scrotum and penis.
Step 5: Conclude.
Only the ilioinguinal nerve fits both the location of injury and the area of numbness.
\[ \boxed{\text{Ilioinguinal nerve}} \]
Inguinal hernia surgery works directly on the inguinal canal, where the spermatic cord and a nearby sensory nerve both run close to the sutures and mesh used to repair the defect.
Step 2: Identify the nerve that sits in this exact path.
The ilioinguinal nerve travels through this same canal and comes out at the superficial inguinal ring, making it one of the nerves most often caught, stretched, or trapped in scar tissue during the operation.
Step 3: Connect the nerve to its sensory territory.
It supplies the skin at the root of the penis and upper scrotum, so when it is injured, the patient feels numbness or tingling exactly in that region, matching the symptom in the question.
Step 4: Rule out nerves with a different territory or path.
The pudendal nerve reaches the genitals by a deeper perineal route, away from the hernia field. The genitofemoral nerve's genital branch mainly drives the cremaster muscle rather than skin sensation at this site. The iliohypogastric nerve covers the suprapubic skin, higher up than the scrotum and penis.
Step 5: Conclude.
Only the ilioinguinal nerve fits both the location of injury and the area of numbness.
\[ \boxed{\text{Ilioinguinal nerve}} \]
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