Recognition and treatment of endometriosis involving the sacral nerve roots

Recognition and treatment of endometriosis involving the sacral nerve roots

Author Lemos, Nucelio Autor UNIFESP Google Scholar
D'Amico, Nicolau Google Scholar
Marques, Renato Autor UNIFESP Google Scholar
Kamergorodsky, Gil Autor UNIFESP Google Scholar
Schor, Eduardo Autor UNIFESP Google Scholar
Girão, Manoel João Batista Castello Autor UNIFESP Google Scholar
Abstract Introduction and hypothesis Endometriosis involving the sacral plexus is still poorly understood or neglected by many surgeons. Looking at that scenario, we have designed this educational video to explain and describe the symptoms suggestive of endometriotic involvement of the sacral plexus in addition to the technique for the laparoscopic treatment of this condition. Methods Retrospective analysis of 13 consecutive cases of endometriotic entrapment of nerves of the lumbosacral plexus. Results Paired t test revealed a statistically significant (p < 0.0000001) reduction in pain VAS score, from preoperative average 9.1 (+/- 1.98) to postoperative 1.46 (+/- 1.66). Twelve out of 13 patients (92.3 %) experienced a reduction of 50 % or more in VAS score and 6 (46.15 %) became completely pain-free. Conclusion The signs suggestive of intrapelvic nerve involvement include perineal pain or pain irradiating to the lower limbs, lower urinary tract symptoms, tenesmus or dyschezia associated with gluteal pain. Whenever deeply infiltrating lesions are present, the patient must be asked about those symptoms and specific MRI sequences for the sacral plexus must be taken, so that the equipment and team can be arranged and proper treatment performed.
Keywords Deeply Infiltrating Endometriosis
Laparoscopy
Lumbosacral Plexus
Urinary Symptoms
Sciatica
Pudendal Pain
Language English
Sponsor Medtronic Inc.
Laborie Inc.
Abbott Inc.
Libbs Inc.
AstraZeneca Inc.
Date 2016
Published in International Urogynecology Journal. London, v. 27, n. 1, p. 147-150, 2016.
ISSN 0937-3462 (Sherpa/Romeo, impact factor)
Publisher Springer london ltd
Extent 147-150
Origin https://doi.org/10.1007/s00192-015-2703-z
Access rights Closed access
Type Article
Web of Science ID WOS:000369522200019
URI http://repositorio.unifesp.br/handle/11600/49627

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