Femoral Neuropathy Subsequent to Abdominal Hysterectomy

Jeong, Ji Wook; Park, Ji Kwon; Cho, Hyon Churl; Choi, Won Jun; Lee, Soon Ae; Lee, Jong Hak; Paik, Won Young

Abstract

OBJECTIVE
To evaluate the clinical factors that contribute to femoral neuropathy subsequent to abdominal hysterectomy.
METHODS
From March 1993 to March 2000, retrospective study on 17 cases of femoral neuropathy subsequent to abdominal hysterectomy was performed. Sixty eight patients who had normal neurologic finding on the lower extremities after the same operation were used as a control group.
RESULTS
The incidence of femoral neuropathy subsequent to abdominal hysterectomy was 1.67%. Age, body weight, parity and type of skin incision were significantly different between study and control group. The mean age of the study group was 38.1+6.1 years and that of the control group was 43.2+/-8.9 years(p<0.05). The mean body weight of the study group was 52.9 6.4kg, while that of the control group was 57.8+/-7.4kg(p<0.05). The mean parity of the study group was 1.9+/-0.7 as opposed to 2.6+/-1.3 for the control group(p<0.05). Pfannenstiel`s incision was performed in 13 cases(76.5%) in the study group as opposed to 34 cases(50%) in the control group(p<0.05). There were no correlation between these two groups with respect to patient height, operative time, transfusion and change in hemoglobin level. In the study group, 13 cases(76.5%) with femoral neuropathy on the left side were found, 3 cases(17.6%) on the right side and 1 case(5.9%) on both side. Left side femoral neuropathy was more common than the right(p<0.05). Spontaneous recovery occurred in 16 cases of the study group within 4 months and, although residual symptoms were noted in the remaining 1 case, no serious sequelae have been observed.
CONCLUSION
It was suggested that pelvic retractor compresses the femoral nerve during the abdominal hysterectomy. The patients age, body weight, parity and a type of skin incision could be contributing factors to femoral neuropathy.