Differential Diagnosis for Nerve Injury Following Robotic Prostatectomy
Single most likely diagnosis
- Lateral femoral cutaneous nerve (LFCN) injury: The patient's symptoms of decreased sensation along the anteriomedial thigh are consistent with LFCN injury, which can occur due to compression or stretching during robotic prostatectomy. The LFCN is responsible for sensation in this area, and its injury can lead to numbness or paresthesia.
Other Likely diagnoses
- Femoral nerve injury: The femoral nerve controls motor function in the lower extremity, and its injury can result in weakness. During robotic prostatectomy, the femoral nerve may be at risk due to its proximity to the surgical site.
- Obturator nerve injury: The obturator nerve also controls motor function in the lower extremity, particularly in the adductor muscles. Injury to this nerve can cause weakness and may occur during robotic prostatectomy due to its location near the surgical site.
Do Not Miss diagnoses
- Cauda equina syndrome: Although less likely, cauda equina syndrome is a serious condition that requires prompt attention. It can occur due to compression or injury to the nerve roots in the lumbar spine during surgery, leading to severe neurological deficits, including lower extremity weakness and sensory changes.
- Spinal epidural hematoma: This is a rare but potentially life-threatening condition that can occur after surgery, causing compression of the spinal cord and leading to severe neurological deficits.
Rare diagnoses
- Lumbosacral plexus injury: Injury to the lumbosacral plexus is a rare complication of robotic prostatectomy, but it can cause significant neurological deficits, including lower extremity weakness and sensory changes.
- Nerve root avulsion: This is a rare injury that can occur during surgery, where a nerve root is torn from the spinal cord, leading to severe and potentially permanent neurological deficits.