Vascular entrapment of the sciatic plexus causing catamenial sciatica and urinary symptoms
Aim of the video / Introduction Pelvic 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 nerve...
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creator | Lemos, Nucelio Marques, Renato Moretti Kamergorodsky, Gil Ploger, Christine Schor, Eduardo Girão, Manoel J. B. C. |
description | Aim of the video / Introduction
Pelvic 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.
Method
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.
Result
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.
Conclusion
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. |
doi_str_mv | 10.1007/s00192-015-2777-7 |
format | Article |
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Pelvic 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.
Method
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.
Result
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.
Conclusion
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.</description><identifier>ISSN: 0937-3462</identifier><identifier>EISSN: 1433-3023</identifier><identifier>DOI: 10.1007/s00192-015-2777-7</identifier><identifier>PMID: 26209951</identifier><language>eng</language><publisher>London: Springer London</publisher><subject>Adult ; Endometriosis - complications ; Endometriosis - surgery ; Female ; Gynecology ; Humans ; IUJ Video ; Ligaments - pathology ; Ligaments - surgery ; Lower Urinary Tract Symptoms - etiology ; Medicine ; Medicine & Public Health ; Nerve Compression Syndromes - etiology ; Nerve Compression Syndromes - surgery ; Sciatic Nerve ; Sciatica - etiology ; Sigmoid Diseases - complications ; Sigmoid Diseases - surgery ; Urology ; Vascular Malformations - complications ; Vascular Malformations - surgery ; Veins - abnormalities ; Veins - surgery</subject><ispartof>International Urogynecology Journal, 2016-02, Vol.27 (2), p.317-319</ispartof><rights>The International Urogynecological Association 2015</rights><rights>The International Urogynecological Association 2016</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-d83681782c6e4f52d32d742fa9065a291a0729e20c649a5e697a6e17e1b27d483</citedby><cites>FETCH-LOGICAL-c372t-d83681782c6e4f52d32d742fa9065a291a0729e20c649a5e697a6e17e1b27d483</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00192-015-2777-7$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00192-015-2777-7$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27903,27904,41467,42536,51297</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26209951$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lemos, Nucelio</creatorcontrib><creatorcontrib>Marques, Renato Moretti</creatorcontrib><creatorcontrib>Kamergorodsky, Gil</creatorcontrib><creatorcontrib>Ploger, Christine</creatorcontrib><creatorcontrib>Schor, Eduardo</creatorcontrib><creatorcontrib>Girão, Manoel J. B. C.</creatorcontrib><title>Vascular entrapment of the sciatic plexus causing catamenial sciatica and urinary symptoms</title><title>International Urogynecology Journal</title><addtitle>Int Urogynecol J</addtitle><addtitle>Int Urogynecol J</addtitle><description>Aim of the video / Introduction
Pelvic 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.
Method
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.
Result
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.
Conclusion
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.</description><subject>Adult</subject><subject>Endometriosis - complications</subject><subject>Endometriosis - surgery</subject><subject>Female</subject><subject>Gynecology</subject><subject>Humans</subject><subject>IUJ Video</subject><subject>Ligaments - pathology</subject><subject>Ligaments - surgery</subject><subject>Lower Urinary Tract Symptoms - etiology</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Nerve Compression Syndromes - etiology</subject><subject>Nerve Compression Syndromes - surgery</subject><subject>Sciatic Nerve</subject><subject>Sciatica - etiology</subject><subject>Sigmoid Diseases - complications</subject><subject>Sigmoid Diseases - surgery</subject><subject>Urology</subject><subject>Vascular Malformations - complications</subject><subject>Vascular Malformations - surgery</subject><subject>Veins - abnormalities</subject><subject>Veins - surgery</subject><issn>0937-3462</issn><issn>1433-3023</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp1kMtKBDEQRYMoOj4-wI0E3LhprVS6k8lSxBcIbtSFm1Cm09rSL5Nu0L8344wigqu7yKlblcPYvoBjAaBPIoAwmIEoMtRaZ3qNzUQuZSYB5TqbgZE6k7nCLbYd4ysA5FDAJttChWBMIWbs8YGimxoK3HdjoKFNwfuKjy-eR1fTWDs-NP59itzRFOvuOeVICaup-SaIU1fyKdQdhQ8eP9ph7Nu4yzYqaqLfW-UOu784vzu7ym5uL6_PTm8yJzWOWTmXai70HJ3yeVVgKbHUOVZkQBWERhBoNB7BqdxQ4ZXRpLzQXjyhLvO53GFHy94h9G-Tj6Nt6-h801Dn-ylaoRUaJZQqEnr4B33tp9Cl674oKTGXOlFiSbnQxxh8ZYdQt-lrVoBdiLdL8TaJtwvxdjFzsGqenlpf_kx8m04ALoGYnrpnH36t_rf1Ezs9jTg</recordid><startdate>20160201</startdate><enddate>20160201</enddate><creator>Lemos, Nucelio</creator><creator>Marques, Renato Moretti</creator><creator>Kamergorodsky, Gil</creator><creator>Ploger, Christine</creator><creator>Schor, Eduardo</creator><creator>Girão, Manoel J. B. C.</creator><general>Springer London</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20160201</creationdate><title>Vascular entrapment of the sciatic plexus causing catamenial sciatica and urinary symptoms</title><author>Lemos, Nucelio ; Marques, Renato Moretti ; Kamergorodsky, Gil ; Ploger, Christine ; Schor, Eduardo ; Girão, Manoel J. B. C.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c372t-d83681782c6e4f52d32d742fa9065a291a0729e20c649a5e697a6e17e1b27d483</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adult</topic><topic>Endometriosis - complications</topic><topic>Endometriosis - surgery</topic><topic>Female</topic><topic>Gynecology</topic><topic>Humans</topic><topic>IUJ Video</topic><topic>Ligaments - pathology</topic><topic>Ligaments - surgery</topic><topic>Lower Urinary Tract Symptoms - etiology</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Nerve Compression Syndromes - etiology</topic><topic>Nerve Compression Syndromes - surgery</topic><topic>Sciatic Nerve</topic><topic>Sciatica - etiology</topic><topic>Sigmoid Diseases - complications</topic><topic>Sigmoid Diseases - surgery</topic><topic>Urology</topic><topic>Vascular Malformations - complications</topic><topic>Vascular Malformations - surgery</topic><topic>Veins - abnormalities</topic><topic>Veins - surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lemos, Nucelio</creatorcontrib><creatorcontrib>Marques, Renato Moretti</creatorcontrib><creatorcontrib>Kamergorodsky, Gil</creatorcontrib><creatorcontrib>Ploger, Christine</creatorcontrib><creatorcontrib>Schor, Eduardo</creatorcontrib><creatorcontrib>Girão, Manoel J. 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B. C.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Vascular entrapment of the sciatic plexus causing catamenial sciatica and urinary symptoms</atitle><jtitle>International Urogynecology Journal</jtitle><stitle>Int Urogynecol J</stitle><addtitle>Int Urogynecol J</addtitle><date>2016-02-01</date><risdate>2016</risdate><volume>27</volume><issue>2</issue><spage>317</spage><epage>319</epage><pages>317-319</pages><issn>0937-3462</issn><eissn>1433-3023</eissn><abstract>Aim of the video / Introduction
Pelvic 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.
Method
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.
Result
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.
Conclusion
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.</abstract><cop>London</cop><pub>Springer London</pub><pmid>26209951</pmid><doi>10.1007/s00192-015-2777-7</doi><tpages>3</tpages></addata></record> |
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subjects | Adult Endometriosis - complications Endometriosis - surgery Female Gynecology Humans IUJ Video Ligaments - pathology Ligaments - surgery Lower Urinary Tract Symptoms - etiology Medicine Medicine & Public Health Nerve Compression Syndromes - etiology Nerve Compression Syndromes - surgery Sciatic Nerve Sciatica - etiology Sigmoid Diseases - complications Sigmoid Diseases - surgery Urology Vascular Malformations - complications Vascular Malformations - surgery Veins - abnormalities Veins - surgery |
title | Vascular entrapment of the sciatic plexus causing catamenial sciatica and urinary symptoms |
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