Laparoscopic Resection of Deep Infiltrating Endometriosis Affecting the Sciatic Nerve: A Case Report of Neurolysis and Fertility Preservation

Sara Iacoponi, Ana Conde, Carmen Yelo, María F Chereguini, Rafael Navarro, Javier De Santiago
In: Journal of Gynecologic Surgery · 2026 · vol. 42(3) , pp. 109–112 · doi:10.1177/10424067261449711 · W7160403213
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This case report details a successful laparoscopic excision and neurolysis for deep infiltrating endometriosis affecting the sciatic nerve in a nulligravid patient, achieving symptom relief and preserving fertility.

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Abstract

Introduction: Sciatic nerve endometriosis is a rare but debilitating form of deep infiltrating endometriosis (DIE) that typically presents with cyclical, refractory sciatica. Management requires meticulous surgical planning and a multidisciplinary approach to achieve both neurological relief and fertility preservation. Case Presentation: A 37-year-old nulligravid patient presented with severe, debilitating left-sided sciatica unresponsive to hormonal treatment. Transvaginal ultrasound and pelvic magnetic resonance imaging revealed a large nodule reaching the left obturator internus and piriformis muscles. A complete laparoscopic excision was performed. Complete excision of the nodule infiltrating the obturator internus muscle was achieved, followed by nerve neurolysis. Conclusion: Complete laparoscopic excision offers a safe and effective treatment for sciatic nerve endometriosis, providing excellent symptom relief. This video highlights the necessary anatomical landmarks and surgical technique for safe neurolysis in the context of DIE.
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endometriosisdie_deep_infiltrating

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