Intrapelvic causes of sciatica: A systematic review

Ahmet Kale
In: Southern Clinics of Istanbul Eurasia · 2021 · doi:10.14744/scie.2020.53954 · W3125835224
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This systematic review explores how various intrapelvic pathologies, often overlooked, can cause sciatica and lead to effective pain management through appropriate treatment.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-09 · read from full text ⓘ

This systematic review examined intrapelvic causes of sciatica, focusing on gynecological, vascular, traumatic, inflammatory, and tumoral conditions that can irritate or compress the sciatic nerve rather than the more typical lower lumbar disc or nerve root sources. Across the literature, the review highlights that intrapelvic pathologies that can mimic disc herniation are often overlooked, and it notes that surgical exploration—particularly laparoscopy or robotic approaches—has increased awareness of these causes. The authors’ key caveat is that management decisions (whether medical versus surgical therapy is warranted) depend on detailed patient assessment, and the review provides no single unified protocol or treatment effectiveness estimate in the text provided. Relevance to endometriosis: the paper explicitly lists endometriosis among the keywords/intrapelvic causes of sciatica, though the provided text does not specify which endometriosis-specific findings are reported beyond this inclusion.

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Abstract

The sciatic nerve is the nerve of the lower limb. It is derived from spinal nerves, fourth Lumbar (L4) to third Sacral (S3). The sciatic nerve innervates the muscles of the posterior thigh and additionally has sensory functions. Sciatica is the given name to the pain sourced by irritation of the sciatic nerve. Sciatica is most commonly induced by compression of a lower lumbar nerve root (L4, L5, or S1). Various intrapelvic pathologies include gynecological, vascular, traumatic, inflammatory, and tumoral disorders that may cause sciatica. Intrapelvic pathologies that mimic disc herniation are quite always ignored. Surgical approach and a functional exploration by laparoscopy or robotic surgery have significantly increased the intrapelvic pathology's awareness, resulting in sciatica. After a detailed assessment of the patient, which causes intrapelvic pathologies, deciding whether surgical or medical therapy is needed, notable results in sciatic pain remission can be done.
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South Clin Ist Euras. 2021; 32(1): 86-94 | DOI: 10.14744/scie.2020.59354 Intrapelvic Causes of Sciatica: A Systematic Review Ahmet Kale1, Betul Kuru1, Gulfem Basol1, Elif Cansu Gundogdu1, Emre Mat1, Gazi Yıldız1, Navdar Doğuş Uzun2, Taner A Usta31Department of Gynecology and Obstetrics, University of Health Sciences, Kartal Dr. Lütfi Kırdar Training and Research Hospital, İstanbul, Turkey 2Department of Gynecology and Obstetrics, Midyat State Hospital, Mardin, Turkey 3Department of Gynecology and Obstetrics, Altunizade Hospital, Acibadem University, Istanbul, Turkey Siyataljinin İntrapelvik Nedenleri: Sistematik Bir Derleme Ahmet Kale1, Betul Kuru1, Gulfem Basol1, Elif Cansu Gundogdu1, Emre Mat1, Gazi Yıldız1, Navdar Doğuş Uzun2, Taner A Usta31Kartal Dr. Lütfi Kırdar Eğitim ve Araştırma Hastanesi, Sağlık Bilimleri Üniversitesi, Kadın Hastalıkları ve Doğum Kliniği, İstanbul, Türkiye 2Midyat Devlet Hastanesi, Kadın Hastalıkları ve Doğum Kliniği, Mardin, Türkiye 3Acibadem Üniversitesi, Altunizade Hastanesi, Kadın Hastalıkları ve Doğum Kliniği, İstanbul, Türkiye 2Department of Gynecology and Obstetrics, Midyat State Hospital, Mardin, Turkey 3Department of Gynecology and Obstetrics, Altunizade Hospital, Acibadem University, Istanbul, Turkey The sciatic nerve is the nerve of the lower limb. It is derived from spinal nerves, fourth Lumbar (L4) to third Sacral (S3). The sciatic nerve innervates the muscles of the posterior thigh and additionally has sensory functions. Sciatica is the given name to the pain sourced by irritation of the sciatic nerve. Sciatica is most commonly induced by compression of a lower lumbar nerve root (L4, L5, or S1). Various intrapelvic pathologies include gynecological, vascular, traumatic, inflammatory, and tumoral disorders that may cause sciatica. Intrapelvic pathologies that mimic disc herniation are quite always ignored. Surgical approach and a functional exploration by laparoscopy or robotic surgery have significantly increased the intrapelvic pathology’s awareness, resulting in sciatica. After a detailed assessment of the patient, which causes intrapelvic pathologies, deciding whether surgical or medical therapy is needed, notable results in sciatic pain remission can be done. Keywords: Endometriosis, intrapelvic cause; pain; schwannoma; sciatica. 2Midyat Devlet Hastanesi, Kadın Hastalıkları ve Doğum Kliniği, Mardin, Türkiye 3Acibadem Üniversitesi, Altunizade Hastanesi, Kadın Hastalıkları ve Doğum Kliniği, İstanbul, Türkiye Siyatik sinir, alt ekstremitenin bir siniridir. Spinal sinirlerden; dördüncü Lomber’den (L4) üçüncü Sakral’a (S3) kadar olan sinir köklerinin birleşmesi ile oluşur. Siyatik sinir, arka uyluk kaslarını innerve eder ve ek olarak duyusal fonksiyonu vardır. Siyatalji, siyatik sinirin irritasyonundan kaynaklanan ağrıya verilen isimdir. Siyatalji en yaygın olarak alt lomber sinir köklerinin (L4, L5 veya S1) sıkışması ile indüklenir. Jinekolojik, vasküler, travmatik, enflamatuvar ve tümöral bozukluklar gibi çeşitli intrapelvik patolojiler siyataljiye neden olabilir. Disk herniasyonunu taklit eden intrapelvik patolojiler çoğunlukla göz ardı edilir. Cerrahi yaklaşım ve laparoskopi veya robotik cerrahi ile fonksiyonel keşif, siyataljiye neden olabilen intrapelvik patolojilerin farkındalığını önemli ölçüde arttırmıştır. Hastanın intrapelvik patolojilere açısından detaylı incelenmesinin ardından cerrahi veya medikal tedavi gerekliliğine karar verilir; siyatik ağrı remisyonunda kayda değer sonuçlar alınabilir. Anahtar Kelimeler: Ağrı, endometriyozis; intrapelvik neden; schwannoma; siyatik. Corresponding Author: Ahmet Kale, Türkiye Manuscript Language: English Manuscript Language: English

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