A rare case of perineal neuralgia treated with ultrasound-guided nerve block combined with water separation

A middle-aged man experienced intermittent acupuncture-like pain in the skin of the right scrotum and medial thigh 1 month after undergoing laparoscopic high ligation of the right hernial sac for a right indirect inguinal hernia in November 2020, and the pain persisted for 6 months. Under ultrasound guidance, ilioinguinal and genitofemoral nerve block and local adhesion water separation were performed with a mixture of 0.25% lidocaine (6 mL) plus prednisolone acetate (10 mg), and the same drugs and methods were repeated five times once a week. After five treatments, the visual analogue scale (VAS) score was reduced from 7 before treatment to 1. During the follow-up period, at 3 months after the end of treatment, the VAS score remained at 0, and this score was sustained at 0 even at the 6-month follow-up. These outcomes indicate that ultrasound-guided nerve block combined with water separation technology can effectively alleviate neuralgia caused by surgical adhesion, which holds important clinical significance in managing such conditions.