Postherniotomy dysejaculation: successful treatment with mesh removal and nerve transection

Dysejaculation following groin hernia repair can occur in about 1-2% of patients, resulting in impairment of sexual function. We report a case of chronic postherniotomy dysejaculation treated with transection of the ilioinguinal and iliohypogastric nerves and decompression of vas deferens that was embedded and twisted in shrunken mesh and scar tissue. At three months follow-up, there was reduced overall pain and no dysejaculation, and quantitative sensory testing showed reversal of sensory abnormalities, except for sensory loss, compared with preoperative values.