Comparison of Isolated Sciatic Nerve and Sacral Nerve Root Endometriosis: A Review of the Literature

Kale, Ahmet; Baydili, Kürşad Nuri; Keleş, Esra; Gündoğdu, Elif Cansu; Usta, Taner; Oral, Engin

doi:10.1016/j.jmig.2022.05.017

Cited by 10 publications

(4 citation statements)

References 55 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…They experience worsening sciatic pain that usually begins in the gluteal area and radiates down the posterolateral side of the leg and heel [22]. Consistent with our case and the mass localization, patients more commonly exhibit leg motor weakness and sciatic dermatome hypoesthesia [24]. Interestingly, Possover noted that less than 20% of isolated sciatic endometriosis cases within the first year of experiencing pain are accompanied by neurologic disorders such as foot drop, Trendelenburg gait, sacral hypoesthesia, and gluteal atrophy [8].…”

Section: Discussionsupporting

confidence: 85%

Isolated Deep Infiltrating Endometriosis of the Sciatic Nerve: A Case Report and Overview of the Literature

Zamurovic,

Tomic,

Djordjevic

et al. 2023

Medicina

View full text Add to dashboard Cite

Isolated deep infiltrating endometriosis (DIE) of sacral nerve roots or major pelvic nerves, including the sciatic nerve, is considered to be extremely rare. Due to the overlap with sciatica symptoms, the diagnosis of sciatica DIE is difficult yet crucial, as it results in permanent neural damage if left untreated. We report a case of a 45-year-old woman who experienced a three-year-long and recently exacerbating pain in her right leg, accompanied by a tingling sensation and weakness in her right leg and foot, with difficulty walking. In between regular menstrual bleedings, when her aforementioned symptoms worsened, she had been experiencing mild 10-day extra-cyclical bleeding. Her neurologist’s, orthopedist’s, and gynecological examinations were unremarkable. Magnetic resonance imaging (MRI) showed an infiltrative lesion on the right sciatic nerve that was immunohistochemically confirmed to be endometriosis. The patient was treated with gonadotropin-releasing hormone analogues (GnRHa), which led to a significantly diminished size of the lesion on the control MRI, and endometriosis remission was obtained. For persistent mild, but cyclical, pain and muscle weakness, continuous progestagnes were administered, with advice for physical therapy provided for her neuro-muscle rehabilitation and a scheduled check-up in 6 months.

show abstract

Section: Discussionsupporting

confidence: 85%

Isolated Deep Infiltrating Endometriosis of the Sciatic Nerve: A Case Report and Overview of the Literature

Zamurovic,

Tomic,

Djordjevic

et al. 2023

Medicina

View full text Add to dashboard Cite

show abstract

“…Characteristic symptoms, like pain or paresthesia radiating to the perineum and the ipsilateral lower limbs and corresponding dermatome, i.e. sacral radiculopathy, may lead to the suspicion of disease 23 . However, a diagnosis cannot be made on the basis of these symptoms alone.…”

Section: Discussionmentioning

confidence: 99%

Clinical and ultrasound characteristics of deep endometriosis affecting sacral plexus

Szabó,

Bokor,

Fancsovits

et al. 2024

Ultrasound in Obstet & Gyne

View full text Add to dashboard Cite

ObjectivesTo describe sonomorphological changes and appearance of deep endometriosis (DE) affecting the nervous tissue of the sacral plexus (SP).MethodsThis was a retrospective study of symptomatic female patients who underwent radical resection of histologically confirmed DE affecting the SP who had undergone preoperative transvaginal sonography (TVS). Between 2019 and 2023 lesions were described based on the terms and definitions of the International Deep Endometriosis Analysis (IDEA) group. DE affecting the SP was diagnosed on ultrasound by TVS, when sonographic criteria of DE were visualized in conjunction with fibers of the SP and the presence of related symptoms, so‐called sacral radiculopathy. Clinical symptoms, ultrasound features and histological confirmation were analyzed for each patient included.ResultsTwenty‐seven patients with DE infiltrating the sacral plexus were identified in 2 contributing tertiary referral centers. Median age was 37 (range, 29–45) years and all of the patients were symptomatic and presented one or more of the following neurological symptoms: dysaesthesia in the ipsilateral lower extremity (n = 17), paraesthesia in the ipsilateral lower extremity (n = 10), chronic pelvic pain radiating in the ipsilateral lower extremity (n = 9), chronic pain radiating in the pudendal region (n = 8), weakness in the ipsilateral lower extremities (n = 3). All DE lesions affecting the SP were purely solid tumors in the posterior parametrium in direct contact with or infiltrating the S1 and/or S2 and/or S3 and/or S4 roots of the SP. The median of the largest diameter of the DE nodules was 35 mm and echogenicity of the DE nodules was in 86% (n=23) non‐uniform. All but one of them contained hyperechoic areas. The shape of the lesions was in 89% (n=24)irregular. Only one lesion exhibited lobulated form, all other irregular lesion showed spiculated appearance. 74% (n=20) of the nodules gave an acoustic shadow, all of them internal. With color or power Doppler examination 78% (n=21) of the nodules showed no signal (Color Score 1). The remaining 22% (n=6) of the lesions manifested only a minimal color content (Color Score 2).According to pattern recognition, most DE nodules were a purely solid non‐uniform hypoechoic nodule with hyperechoic areas, internal shadows and irregular spiculated contours and poorly vascularized at color/power Doppler examination.ConclusionThe ultrasound finding of a parametrial unilateral solid non‐uniform hypoechoic nodule with hyperechoic areas and possible internal shadowing as well as irregular spiculated contours demonstrating poor vascularization on Doppler examination in proximity or involving the structures of the SP reflects DE affecting these structures.This article is protected by copyright. All rights reserved.

show abstract

“…Its origin can be found in the obturator fossa. Its laparoscopic approach consists of locating the lumbosacral trunk and exposing the sciatic nerve leaving the pelvis through the suprapiriformis canal [22]. these organs and the central nervous system [26] (table 1).…”

Section: Somaticmentioning

confidence: 99%

Anatomy and Generalities of the Pelvic Nerves, Neuropelveology, A Discipline for the Management and Approach of Chronic Pelvic Pain: Review of the Literature

Alverde,

Vasco Rivero,

Vionet

et al. 2024

Act Sci wom hea

View full text Add to dashboard Cite

nerve injuries associated with chronic pelvic pain (CPP), which is the main symptom for which patients seek gynecology services.CPP affects multiple organs due to the connection of the intrapelvic organs and their innervation with the autonomic and somatic nerve plexuses. Therefore, NP involves a multidisciplinary approach, primarily neurological, gynecological, neurosurgical, urological, and colorectal. Objective: To understand the general aspects of NP and its application in CPP. Methods: A systematic search was conducted in Pubmed using the following keywords: Neuropelveology, chronic pelvic pain, and pelvic nerves. The inclusion criteria were as follows: availability of the text and original and review articles with publication dates from 2008 to 2023, excluding articles that were not in English and not indexed. Results: We described the most important endpoints of NP found in the literature and made a table to understand the importance of NP in CPP.

show abstract

Comparison of Isolated Sciatic Nerve and Sacral Nerve Root Endometriosis: A Review of the Literature

Cited by 10 publications

References 55 publications

Isolated Deep Infiltrating Endometriosis of the Sciatic Nerve: A Case Report and Overview of the Literature

Isolated Deep Infiltrating Endometriosis of the Sciatic Nerve: A Case Report and Overview of the Literature

Clinical and ultrasound characteristics of deep endometriosis affecting sacral plexus

Anatomy and Generalities of the Pelvic Nerves, Neuropelveology, A Discipline for the Management and Approach of Chronic Pelvic Pain: Review of the Literature

Contact Info

Product

Resources

About