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

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dc.citation.issue2
dc.citation.volume27
dc.contributor.authorLemos, Nucelio [UNIFESP]
dc.contributor.authorMarques, Renato Moretti [UNIFESP]
dc.contributor.authorKamergorodsky, Gil [UNIFESP]
dc.contributor.authorPloger, Christine [UNIFESP]
dc.contributor.authorSchor, Eduardo [UNIFESP]
dc.contributor.authorGirao, Manoel J. B. C. [UNIFESP]
dc.coverageLondon
dc.date.accessioned2020-11-03T14:40:32Z
dc.date.available2020-11-03T14:40:32Z
dc.date.issued2016
dc.description.abstractPelvic congestion syndrome is a well-known cause of cyclic pelvic pain (Ganeshan et al., Cardiovasc Intervent Radiol 30(6):1105-11, 2007). What is much less well known is 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 that are not commonly seen in gynecological practice, such as sciatica, or refractory urinary and anorectal dysfunction (Possover et al., Fertil Steril 95(2):756-8. 2011). The objective of this video is to explain and describe the symptoms suggestive of vascular entrapment of the sacral plexus, as well as the technique for the laparoscopic decompression of these nerves. Two anecdotal cases of intrapelvic vascular entrapment are used to review the anatomy of the lumbosacral plexus and demonstrate the laparoscopic surgical technique for decompression at two different sites, one on the sciatic nerve and one on the sacral nerve roots. After surgery, the patient with the sciatic entrapment showed full recovery of the sciatica and partial recovery of the myofascial pain. The patient with sacral nerve root entrapment showed full recovery with resolution of symptoms. The symptoms suggestive of intrapelvic nerve entrapment are: perineal pain or pain irradiating to the lower limbs in the absence of a spinal disorder, and lower urinary tract symptoms in the absence of prolapse of a bladder lesion. In the presence of such symptoms, the radiologist should provide specific MRI sequences of the intrapelvic portion of the sacral plexus and a team and equipment to expose and decompress the sacral nerves should be prepared.en
dc.description.affiliationUniv Fed Sao Paulo, Dept Obstet & Gynecol, Pelv Neurodysfunct Clin, Rua Jose de Magalhaes 373 Ap904, BR-04026090 Sao Paulo, SP, Brazil
dc.description.affiliationUnifespUniv Fed Sao Paulo, Dept Obstet & Gynecol, Pelv Neurodysfunct Clin, Rua Jose de Magalhaes 373 Ap904, BR-04026090 Sao Paulo, SP, Brazil
dc.description.sourceWeb of Science
dc.description.sponsorshipMedtronic Inc.
dc.description.sponsorshipLaborie Inc.
dc.description.sponsorshipAbbott Inc.
dc.description.sponsorshipLibbs Inc.
dc.description.sponsorshipAstraZeneca Inc.
dc.format.extent317-319
dc.identifierhttps://doi.org/10.1007/s00192-015-2777-7
dc.identifier.citationInternational Urogynecology Journal. London, v. 27, n. 2, p. 317-319, 2016.
dc.identifier.doi10.1007/s00192-015-2777-7
dc.identifier.issn0937-3462
dc.identifier.urihttps://repositorio.unifesp.br/handle/11600/58608
dc.identifier.wosWOS:000370044300020
dc.language.isoeng
dc.publisherSpringer London Ltd
dc.relation.ispartofInternational Urogynecology Journal
dc.rightsAcesso aberto
dc.subjectSciaticaen
dc.subjectPelvic congestion syndromeen
dc.subjectUrinary incontinenceen
dc.subjectLaparoscopyen
dc.subjectNerve entrapment syndromeen
dc.subjectVulvodyniaen
dc.titleVascular entrapment of the sciatic plexus causing catamenial sciatica and urinary symptomsen
dc.typeArtigo
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