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

Detalhes bibliográficos
Autor(a) principal: Lemos, Nucelio [UNIFESP]
Data de Publicação: 2016
Outros Autores: Marques, Renato Moretti [UNIFESP], Kamergorodsky, Gil [UNIFESP], Ploger, Christine [UNIFESP], Schor, Eduardo [UNIFESP], Girao, Manoel J. B. C. [UNIFESP]
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Institucional da UNIFESP
Texto Completo: https://repositorio.unifesp.br/handle/11600/58608
https://doi.org/10.1007/s00192-015-2777-7
Resumo: 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. 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.
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spelling Lemos, Nucelio [UNIFESP]Marques, Renato Moretti [UNIFESP]Kamergorodsky, Gil [UNIFESP]Ploger, Christine [UNIFESP]Schor, Eduardo [UNIFESP]Girao, Manoel J. B. C. [UNIFESP]2020-11-03T14:40:32Z2020-11-03T14:40:32Z2016International Urogynecology Journal. London, v. 27, n. 2, p. 317-319, 2016.0937-3462https://repositorio.unifesp.br/handle/11600/58608https://doi.org/10.1007/s00192-015-2777-710.1007/s00192-015-2777-7WOS:000370044300020Pelvic 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.Medtronic Inc.Laborie Inc.Abbott Inc.Libbs Inc.AstraZeneca Inc.Univ Fed Sao Paulo, Dept Obstet & Gynecol, Pelv Neurodysfunct Clin, Rua Jose de Magalhaes 373 Ap904, BR-04026090 Sao Paulo, SP, BrazilUniv Fed Sao Paulo, Dept Obstet & Gynecol, Pelv Neurodysfunct Clin, Rua Jose de Magalhaes 373 Ap904, BR-04026090 Sao Paulo, SP, BrazilWeb of Science317-319engSpringer London LtdInternational Urogynecology JournalSciaticaPelvic congestion syndromeUrinary incontinenceLaparoscopyNerve entrapment syndromeVulvodyniaVascular entrapment of the sciatic plexus causing catamenial sciatica and urinary symptomsinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleLondon272info:eu-repo/semantics/openAccessreponame:Repositório Institucional da UNIFESPinstname:Universidade Federal de São Paulo (UNIFESP)instacron:UNIFESP11600/586082022-02-08 12:46:02.845metadata only accessoai:repositorio.unifesp.br:11600/58608Repositório InstitucionalPUBhttp://www.repositorio.unifesp.br/oai/requestopendoar:34652023-05-25T12:11:18.220703Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)false
dc.title.en.fl_str_mv Vascular entrapment of the sciatic plexus causing catamenial sciatica and urinary symptoms
title Vascular entrapment of the sciatic plexus causing catamenial sciatica and urinary symptoms
spellingShingle Vascular entrapment of the sciatic plexus causing catamenial sciatica and urinary symptoms
Lemos, Nucelio [UNIFESP]
Sciatica
Pelvic congestion syndrome
Urinary incontinence
Laparoscopy
Nerve entrapment syndrome
Vulvodynia
title_short Vascular entrapment of the sciatic plexus causing catamenial sciatica and urinary symptoms
title_full Vascular entrapment of the sciatic plexus causing catamenial sciatica and urinary symptoms
title_fullStr Vascular entrapment of the sciatic plexus causing catamenial sciatica and urinary symptoms
title_full_unstemmed Vascular entrapment of the sciatic plexus causing catamenial sciatica and urinary symptoms
title_sort Vascular entrapment of the sciatic plexus causing catamenial sciatica and urinary symptoms
author Lemos, Nucelio [UNIFESP]
author_facet Lemos, Nucelio [UNIFESP]
Marques, Renato Moretti [UNIFESP]
Kamergorodsky, Gil [UNIFESP]
Ploger, Christine [UNIFESP]
Schor, Eduardo [UNIFESP]
Girao, Manoel J. B. C. [UNIFESP]
author_role author
author2 Marques, Renato Moretti [UNIFESP]
Kamergorodsky, Gil [UNIFESP]
Ploger, Christine [UNIFESP]
Schor, Eduardo [UNIFESP]
Girao, Manoel J. B. C. [UNIFESP]
author2_role author
author
author
author
author
dc.contributor.author.fl_str_mv Lemos, Nucelio [UNIFESP]
Marques, Renato Moretti [UNIFESP]
Kamergorodsky, Gil [UNIFESP]
Ploger, Christine [UNIFESP]
Schor, Eduardo [UNIFESP]
Girao, Manoel J. B. C. [UNIFESP]
dc.subject.eng.fl_str_mv Sciatica
Pelvic congestion syndrome
Urinary incontinence
Laparoscopy
Nerve entrapment syndrome
Vulvodynia
topic Sciatica
Pelvic congestion syndrome
Urinary incontinence
Laparoscopy
Nerve entrapment syndrome
Vulvodynia
description 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. 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.
publishDate 2016
dc.date.issued.fl_str_mv 2016
dc.date.accessioned.fl_str_mv 2020-11-03T14:40:32Z
dc.date.available.fl_str_mv 2020-11-03T14:40:32Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.citation.fl_str_mv International Urogynecology Journal. London, v. 27, n. 2, p. 317-319, 2016.
dc.identifier.uri.fl_str_mv https://repositorio.unifesp.br/handle/11600/58608
https://doi.org/10.1007/s00192-015-2777-7
dc.identifier.issn.none.fl_str_mv 0937-3462
dc.identifier.doi.none.fl_str_mv 10.1007/s00192-015-2777-7
dc.identifier.wos.none.fl_str_mv WOS:000370044300020
identifier_str_mv International Urogynecology Journal. London, v. 27, n. 2, p. 317-319, 2016.
0937-3462
10.1007/s00192-015-2777-7
WOS:000370044300020
url https://repositorio.unifesp.br/handle/11600/58608
https://doi.org/10.1007/s00192-015-2777-7
dc.language.iso.fl_str_mv eng
language eng
dc.relation.ispartof.none.fl_str_mv International Urogynecology Journal
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv 317-319
dc.coverage.none.fl_str_mv London
dc.publisher.none.fl_str_mv Springer London Ltd
publisher.none.fl_str_mv Springer London Ltd
dc.source.none.fl_str_mv reponame:Repositório Institucional da UNIFESP
instname:Universidade Federal de São Paulo (UNIFESP)
instacron:UNIFESP
instname_str Universidade Federal de São Paulo (UNIFESP)
instacron_str UNIFESP
institution UNIFESP
reponame_str Repositório Institucional da UNIFESP
collection Repositório Institucional da UNIFESP
repository.name.fl_str_mv Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)
repository.mail.fl_str_mv
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