Vascular entrapment of the sciatic plexus causing catamenial sciatica and urinary symptoms

Lemos, Nucelio; Marques, Renato Moretti; Kamergorodsky, Gil; Plöger, Christine; Schor, Eduardo; Girão, Manoel Joâo Batista Castello

doi:10.1007/s00192-015-2777-7

Cited by 14 publications

(11 citation statements)

References 5 publications

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“…Minimally invasive techniques, which allow accessing the pelvic nerves located in the deepest areas of the pelvis with magnification, are the undisputed best approach for management of neurovascular entrapment syndromes. Laparoscopic management for the neurovascular decompression of the sacral plexus has been described . In addition, we laparoscopically demonstrated decompression of malformed branches of the vessels entrapping the nerves of the sacral plexus …”

Section: Discussionmentioning

confidence: 85%

Robot‐assisted laparoscopic management of a vascular entrapment of the sacral nerve roots causing pelvic pain

Usta

Ozkaynak

Kale

et al. 2019

J of Obstet and Gynaecol

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The aim of this case report is to demonstrate the robot-assisted laparoscopic decompression approach to treat the aberrant vessels entrapping the sacral nerves causing pelvic pain. A 34-year-old female patient had been complaining about pelvic pain on the left perineal region which was radiating to the sacral 1-2 nerves dermatome for 3 years. Decompression of sacral nerve roots and sciatic nerve was performed via robotassisted and a four-arm Da Vinci Si Surgical System laparoscopic approach. This case report is the first presentation of robot-assisted laparoscopic management of a vascular entrapment of the sacral nerve roots. The robotic technique offers, three-dimensional vision, improved maneuverability and enhanced ergonomics in the deepest area in the pelvis and could be a valid alternative to laparoscopy in the treatment of intrapelvic neurovascular entrapments.

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Section: Discussionmentioning

confidence: 85%

Robot‐assisted laparoscopic management of a vascular entrapment of the sacral nerve roots causing pelvic pain

Usta

Ozkaynak

Kale

et al. 2019

J of Obstet and Gynaecol

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“…In the cases that unresponsive to medical and physical therapy like in our case, laparoscopic decompression of the entrapped nerves should be a treatment option. 4 Laparoscopic treatment for the vascular decompression of the sacral plexus has been described by Possover and Forman 4 and Lemos et al 2 Although in the early postoperative period, the mildest form of nerve injury-called "neurapraxia"-may occur, these authors have presented a safe approach with high success rates and good treatment outcomes. 9 During the laparoscopic exposure, the obturator space was reached and the aberrant vein that was compressing the sciatic nerve was separated from the nerve via clips.…”

Section: Discussionmentioning

confidence: 99%

“…1 Compression of the nerves of the lumbosacral plexus in the pelvis due to dilated or malformed branches of the internal or external iliac vessels can cause pelvic pain. [2][3][4] The lumbosacral trunk (LST) arises from the ventral rami of the lumbar spinal nerve roots L4 and L5, descending to join the sacral spinal nerve root S1 and contribute to the sacral plexus. 5 In the pelvic region, the LST contributes fibers to the sciatic nerve.…”

Section: Introductionmentioning

confidence: 99%

Sciatic nerve and sacral 2 nerve root decompression by aberrant hypogastric vein branch causing persistent sciatica

Kale¹,

Başol²,

Uzun³

et al. 2018

Journal of Endometriosis and Pelvic Pain Disorders

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The aim of this case to present a woman with neurovascular entrapment causing persistent sciatica. We presented the surgical management and the feasibility, safety, and early postoperative outcomes, as well as step-by-step explanation of the surgical technique that it was enriched via original video footage. Case description: A 29-year-old woman has been suffering from chronic pelvic pain and sciatica for 1 year. She had received medical physical treatment for 6 months and did not have any response to pain. Her visual analog scale score was 8/10 points. Neurovascular entrapment was considered as a preliminary diagnosis. The laparoscopic approach showed that an aberrant hypogastric vein branch compressing the sciatic nerve and sacral 2 nerve root. The decompression of these nerves was performed successfully. The total operation time was 50 min. There was no intraoperative and postoperative complication. The visual analog scale score on the postoperative 24th-h was 1/10 point (on 11-point numeric scale). The patient was discharged on the second day postoperatively. In the first-month follow-up, patient's visual analog scale score was 7/10 point (on 11-point numeric scale). In the 12th-month follow-up, patient's pelvic pain has decreased dramatically (visual analog scale score rate was 0/10 point) and also had no dyspareunia. Conclusion: A gynecologist should be aware of diagnosis of vascular entrapment in the chronic pelvic pain. Moreover, knowledge of pelvic neuroanatomy and clinical neurology is mandatory for surgeons. The surgical management of neurovascular entrapment is a safe, feasible, and curative option when performed by experienced surgeons.

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“…However, what is much less known is the fact that dilated or malformed branches of the internal or external iliac vessels can entrap the nerves of the sacral plexus against the pelvic sidewalls, producing symptoms such as sciatica, or refractory urinary and anorectal dysfunction [ 2 , 14 ] ( Fig. 8 ).…”

Section: Etiology Of Intrapelvic Entrapmentsmentioning

confidence: 99%

Laparoscopic approach to intrapelvic nerve entrapments

Lemos

Possover

2015

Journal of Hip Preservation Surgery

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It is long known that a large portion of the lumbosacral plexus is located intra-abdominally, in the retroperitoneal space. However, most of literature descriptions of lesions on this plexus refer to its extra-abdominal parts whereas its intra-abdominal portions are often neglected. The objective of this review article is to describe the laparoscopic anatomy of intrapelvic nerve bundles, as well as the findings and advances already achieved by Neuropelveology practitioners.

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Vascular entrapment of the sciatic plexus causing catamenial sciatica and urinary symptoms

Cited by 14 publications

References 5 publications

Robot‐assisted laparoscopic management of a vascular entrapment of the sacral nerve roots causing pelvic pain

Robot‐assisted laparoscopic management of a vascular entrapment of the sacral nerve roots causing pelvic pain

Sciatic nerve and sacral 2 nerve root decompression by aberrant hypogastric vein branch causing persistent sciatica

Laparoscopic approach to intrapelvic nerve entrapments

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