• Kenneth S Lee, Jessica M Sin, Priti P Patil, Amgad S Hanna, Jacob A Greenberg, Ryan D Zea, and Christopher L Brace.
• Department of Radiology, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, Madison, WI 53792. Electronic address: Klee2@uwhealth.org.
• J Vasc Interv Radiol. 2019 Feb 1; 30 (2): 242-248.

PurposeTo evaluate the feasibility and efficacy of ultrasound-guided microwave ablation for the treatment of inguinal neuralgia.Materials And MethodsA retrospective review of 12 consecutive ultrasound-guided microwave ablation procedures was performed of 10 consecutive patients (8 men, 2 women; mean age, 41 years [range, 15-64 years]), between August 2012 and August 2016. Inclusion criteria for inguinal neuralgia included clinical diagnosis of chronic inguinal pain (average, 17.3 months [range, 6-46 months]) refractory to conservative treatment and a positive nerve block. Pain response-reduction of pain level and duration and percent pain reduction using a 10-point visual analog scale (VAS) at baseline and up to 12 months after the procedure-was measured. Nine patients had pain after the inguinal hernia repair, and 1 patient had pain from the femoral artery bypass procedure. The microwave ablation procedure targeted the ilioinguinal nerve in 7 cases, the genitofemoral nerve in 4 cases, and the iliohypogastric nerve in 1 case.ResultsAverage baseline VAS pain score was 6.1 (standard deviation, 2.5). Improved pain levels immediately after the procedure and at 1, 6, and 12 months were statistically significant (P = .0037, .0037, .0038, .0058, respectively). Also, 91.7% (11/12) of the procedures resulted in immediate pain relief and at 1 month and 6 months. At 12 months, 83.3% (10/12) of patients had an average of 69% ± 31% pain reduction. Percent maximal pain reduction was 93% ± 14% (60%-100%), and the average duration of clinically significant pain reduction was 10.5 months (range, 0-12 months.). No complications or adverse outcomes occurred.ConclusionsUltrasound-guided microwave ablation is an effective technique for the treatment of inguinal neuralgia after herniorrhaphy.Copyright © 2018 SIR. Published by Elsevier Inc. All rights reserved.

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