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Genitofemoral Nerve Block
Colin J. McCarthy, MB, BCh, BAO, MRCSI, FFR (RCSI); Rafael Vazquez, MD
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KEY FACTS

  • Terminology

    • Preprocedure

      • Procedure

        • Post Procedure

          TERMINOLOGY

          • Abbreviations

            • Genitofemoral neuralgia (GFN)
          • Definitions

            • Genitofemoral nerve arises from ventral rami of L1 and L2
              • Predominantly sensory nerve
              • Descends within psoas muscle, emerges on anterior surface of psoas major
              • Retroperitoneal structure, lies posterior to ureter
              • Divides into genital branch (enters deep inguinal ring) and femoral branch (posterior to inguinal ligament)
                • Genital branch supplies motor fibers to cremasteric muscle in males, together with sensory supply to scrotal skin; in females, it accompanies round ligament of uterus (supply to skin of mons pubis)
                • In thigh, lies deep to fascia lata
                • Femoral branch lies lateral to femoral artery in femoral sheath, supplies skin of upper thigh
              • Injury or irritation to nerve can occur at any point along its length
                • Retroperitoneum
                • Lower abdomen (near external iliac vessels)
                • Inguinal canal
            • GFN is chronic pain associated with genitofemoral nerve, typically involving upper thigh, groin, and scrotum

          PREPROCEDURE

          • Indications

            • Contraindications

              • Preprocedure Imaging

                • Getting Started

                  PROCEDURE

                  • Patient Position/Location

                    • Equipment Preparation

                      • Procedure Steps

                        • Findings and Reporting

                          • Alternative Procedures/Therapies

                            POST PROCEDURE

                            • Expected Outcome

                              • Things To Do

                                • Things To Avoid

                                  OUTCOMES

                                  • Problems

                                    • Complications

                                      Selected References

                                      1. Frassanito L et al: Ultrasound-guided genitofemoral nerve block for inguinal hernia repair in the male adult: a randomized controlled pilot study. Minerva Anestesiol. 84(2):189-95, 2018
                                      2. Fritz J et al: Diagnostic accuracy of selective 3-T MR neurography-guided retroperitoneal genitofemoral nerve blocks for the diagnosis of genitofemoral neuralgia. Radiology. 285(1):176-85, 2017
                                      3. Sakai T et al: A case of scrotal pain associated with genitofemoral nerve injury following cystectomy. J Clin Anesth. 32:150-2, 2016
                                      4. Cesmebasi A et al: Genitofemoral neuralgia: a review. Clin Anat. 28(1):128-35, 2015
                                      5. Hackworth RJ et al: Computed tomographic-guided genitofemoral nerve block: a simple anterior approach. J Comput Assist Tomogr. 39(2):295-7, 2015
                                      6. Shanthanna H: Successful treatment of genitofemoral neuralgia using ultrasound guided injection: a case report and short review of literature. Case Rep Anesthesiol. 2014:371703, 2014
                                      7. Song JW et al: Laparoscopic triple neurectomy for intractable groin pain: technical report of 3 cases. Neurosurgery. 68(2 Suppl Operative):339-46; discussion 346, 2011
                                      8. Campos NA et al: Ultrasound-guided cryoablation of genitofemoral nerve for chronic inguinal pain. Pain Physician. 12(6):997-1000, 2009
                                      9. Muensterer OJ: Genitofemoral nerve injury after laparoscopic varicocelectomy in adolescents. J Urol. 180(5):2155-7; discussion 2157-8, 2008
                                      10. Boss A et al: Thermal damage of the genitofemoral nerve due to radiofrequency ablation of renal cell carcinoma: a potentially avoidable complication. AJR Am J Roentgenol. 185(6):1627-31, 2005
                                      11. Rab M et al: Anatomic variability of the ilioinguinal and genitofemoral nerve: implications for the treatment of groin pain. Plast Reconstr Surg. 108(6):1618-23, 2001
                                      Related Anatomy
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                                      Related Differential Diagnoses
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                                      References
                                      Tables

                                      Tables

                                      KEY FACTS

                                      • Terminology

                                        • Preprocedure

                                          • Procedure

                                            • Post Procedure

                                              TERMINOLOGY

                                              • Abbreviations

                                                • Genitofemoral neuralgia (GFN)
                                              • Definitions

                                                • Genitofemoral nerve arises from ventral rami of L1 and L2
                                                  • Predominantly sensory nerve
                                                  • Descends within psoas muscle, emerges on anterior surface of psoas major
                                                  • Retroperitoneal structure, lies posterior to ureter
                                                  • Divides into genital branch (enters deep inguinal ring) and femoral branch (posterior to inguinal ligament)
                                                    • Genital branch supplies motor fibers to cremasteric muscle in males, together with sensory supply to scrotal skin; in females, it accompanies round ligament of uterus (supply to skin of mons pubis)
                                                    • In thigh, lies deep to fascia lata
                                                    • Femoral branch lies lateral to femoral artery in femoral sheath, supplies skin of upper thigh
                                                  • Injury or irritation to nerve can occur at any point along its length
                                                    • Retroperitoneum
                                                    • Lower abdomen (near external iliac vessels)
                                                    • Inguinal canal
                                                • GFN is chronic pain associated with genitofemoral nerve, typically involving upper thigh, groin, and scrotum

                                              PREPROCEDURE

                                              • Indications

                                                • Contraindications

                                                  • Preprocedure Imaging

                                                    • Getting Started

                                                      PROCEDURE

                                                      • Patient Position/Location

                                                        • Equipment Preparation

                                                          • Procedure Steps

                                                            • Findings and Reporting

                                                              • Alternative Procedures/Therapies

                                                                POST PROCEDURE

                                                                • Expected Outcome

                                                                  • Things To Do

                                                                    • Things To Avoid

                                                                      OUTCOMES

                                                                      • Problems

                                                                        • Complications

                                                                          Selected References

                                                                          1. Frassanito L et al: Ultrasound-guided genitofemoral nerve block for inguinal hernia repair in the male adult: a randomized controlled pilot study. Minerva Anestesiol. 84(2):189-95, 2018
                                                                          2. Fritz J et al: Diagnostic accuracy of selective 3-T MR neurography-guided retroperitoneal genitofemoral nerve blocks for the diagnosis of genitofemoral neuralgia. Radiology. 285(1):176-85, 2017
                                                                          3. Sakai T et al: A case of scrotal pain associated with genitofemoral nerve injury following cystectomy. J Clin Anesth. 32:150-2, 2016
                                                                          4. Cesmebasi A et al: Genitofemoral neuralgia: a review. Clin Anat. 28(1):128-35, 2015
                                                                          5. Hackworth RJ et al: Computed tomographic-guided genitofemoral nerve block: a simple anterior approach. J Comput Assist Tomogr. 39(2):295-7, 2015
                                                                          6. Shanthanna H: Successful treatment of genitofemoral neuralgia using ultrasound guided injection: a case report and short review of literature. Case Rep Anesthesiol. 2014:371703, 2014
                                                                          7. Song JW et al: Laparoscopic triple neurectomy for intractable groin pain: technical report of 3 cases. Neurosurgery. 68(2 Suppl Operative):339-46; discussion 346, 2011
                                                                          8. Campos NA et al: Ultrasound-guided cryoablation of genitofemoral nerve for chronic inguinal pain. Pain Physician. 12(6):997-1000, 2009
                                                                          9. Muensterer OJ: Genitofemoral nerve injury after laparoscopic varicocelectomy in adolescents. J Urol. 180(5):2155-7; discussion 2157-8, 2008
                                                                          10. Boss A et al: Thermal damage of the genitofemoral nerve due to radiofrequency ablation of renal cell carcinoma: a potentially avoidable complication. AJR Am J Roentgenol. 185(6):1627-31, 2005
                                                                          11. Rab M et al: Anatomic variability of the ilioinguinal and genitofemoral nerve: implications for the treatment of groin pain. Plast Reconstr Surg. 108(6):1618-23, 2001