Cases: Two patients developed solitary unilateral peripheral femoral neuropathy after vaginal hysterectomy. Methods: Both were operated under spinal anesthesia in the lithotomy position. Straight rod leg supports with swing stirrups were used, and both of the procedures lasted for approximately 1½ hours. The complication is thought to be due to the extreme abduction of thighs with external rotation at the hip causing ischemia of the femoral nerve as it is kinked beneath the tough inguinal ligament. Conclusions: The prognosis was found to be excellent, with complete recovery within 8–10 weeks. The complication is preventable by using lateral thigh supports, limiting the degree of abduction. The pathophysiology contributing to this operative complication as well as measures for prevention and treatment are discussed. A personal observation and a literary review on femoral neuropathy after vaginal hysterectomy are presented. (J GYNECOL SURG 26:171)
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