Endoscopic lumbar sympathectomy for plantar hyperhidrosis

Abstract

Endoscopic lumbar sympathectomy was a safe and effective option for patients with severe plantar hyperhidrosis.

Long‐term results of the use of oxybutynin for the treatment of plantar hyperhidrosis

“…Patients were young adults (median: 29 years old) as usual for PLH, who seek medical attention around their thirties …”

“…It is our group's opinion that when a patient considers surgical treatment for hyperhidrosis, it is of utmost importance that he or she receives education clarifying the risks concerning the perioperative period and the risk of CH. Regrets following the procedure are, unfortunately, not rare (in one series, 4% of patients who had been operated on would not have the procedure again if they could choose), and preoperative education and a “pharmacological‐first” approach lowers the risk of treatment dissatisfaction for both patients and physicians.…”

“…Non‐operative treatment possibilities (botulinum toxin, iontophoresis, and topical agents) demonstrate limited effectiveness . Lumbar sympathectomy (LS) – either chemical or surgically minimally invasive (endoscopic) – presents good results but with definite risks, such as lymphatic leak, nerve misidentification, and sexual dysfunction …”

Use of oxybutynin for treating plantar hyperhidrosis

“…Injection of botulinum toxin provides good results but only temporarily (<6 months) . Lumbar sympathectomy (LS) provides excellent resolution of PLH, but it is associated with certain complications, particularly compensatory hyperhidrosis…”

Primary focal hyperhidrosis: current treatment options and a step‐by‐step approach

“…Sympathetic denervation is the last step in treating severe palmar, craniofacial and axillary hyperhidrosis (Table 4). Studies in the treatment of plantar hyperhidrosis by lumbar sympathectomy have reported good results at follow‐up 85–87 . The major complication described is sexual dysfunction 87,88 and therefore, fine tuning of the technique is necessary to introduce it as a standard approach.…”