Laparoscopic neurolysis of the pelvic sciatic nerve in a case of catamenial footdrop

Eugenio Volpi, Volpi E, Piero Seinera, P Seinera, Seinera P, Annamaria Ferrero, Daniela Dompè, Dompè D
Journal of Minimally Invasive Gynecology · 2005 · vol. 12(6) , pp. 525–527 · doi:10.1016/j.jmig.2005.09.005 · PMID:16337582 · W2029084895
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This case report details the successful laparoscopic neurolysis of the pelvic sciatic nerve in a patient experiencing catamenial footdrop, a condition linked to menstruation.

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Abstract

Isolated cases of cyclic sciatica associated with endometriosis have been reported since the 1940s. Surgical intervention, either by laparoscopy for lesions within the pelvis or by open procedures for extrapelvic lesions, has usually been performed. A 37-year-old woman with catamenial footdrop and pain of the right thigh came to our observation. Previously, she underwent laparoscopy for bilateral ovarian endometriomas. In a second laparoscopy, we removed her uterosacral right ligament and recto-vaginal endometriotic nodules. After a temporary improvement, a third surgical procedure was necessary: laparoscopic neurolysis to free the sciatic nerve from fibrotic tissue. Then the patient was treated with gonadotropin-releasing hormone analogs for 6 months, and she is free of symptoms 2 years after last surgery. This is the first described case of laparoscopic neurolysis of the proximal sciatic nerve. The procedure has been successful in treating a patient with endometriosis in whom the cause of the syndrome was probably due to entrapment of the nerve in fibrous tissue.

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Gait Disorders, Neurologic Nerve Compression Syndromes Sciatic Nerve Adult Combined Modality Therapy Contraceptives, Oral Contraceptives, Oral Endometriosis Endometriosis Endometriosis Female Gait Disorders, Neurologic Gonadotropin-Releasing Hormone Gonadotropin-Releasing Hormone Humans Laparoscopy Menstruation Nerve Compression Syndromes Nerve Compression Syndromes

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License: CC0 · commercial use OK