Lateral Deep Pelvic Endometriosis. Over Parietal Fascia: Nervous Locations
Neural endometriosis, defined by deep endometriosis compression of epineural tissue, presents diagnostic and surgical challenges requiring detailed evaluation, imaging like MRI, and nerve-sparing techniques for optimal outcomes.
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This chapter reviews neural endometriosis, describing it as compression, infiltration, distortion, and irritation of epineural connective tissue (with or without neural entrapment) caused by deep endometriosis and associated fibrosis. It outlines diagnostic requirements including detailed history, targeted neurological and vaginal examinations, and highlights pelvic MRI (including neurography/tractography concepts) as the method of choice, noting that the complex neural anatomy is a challenge for imaging and surgery. It also summarizes advances in treatment, especially neurolysis laparoscopy with nerve-sparing techniques, emphasizing the role of imaging in identifying surgical risk and planning to reduce functional morbidity, while explicitly stating the importance of multidisciplinary care and early diagnosis. This paper is centrally about endometriosis — it focuses on lateral deep pelvic endometriosis over the parietal fascia and the nervous locations involved.
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