Cyclic Sciatica in a Patient With Deep Monolateral Endometriosis Infiltrating the Right Sciatic Nerve

Abstract

Study Design 

Case report.

Objective 

To show by case presentation, the potential for endometriosis to infiltrate the somatic nerves causing lower extremity neuropathic pain and to discuss possible surgical remedy and the effectiveness of laparoscopic neurolysis.

Summary of Background Data 

Pelvic endometriosis may infiltrate the pelvic wall and somatic nerves causing severe neuropathic symptoms.

Methods 

We report a case of a 41-year-old woman with a history of severe dysmenorrhea, dyspareunia, and chronic pelvic pain with concomitant monolateral right sciatica because of deep infiltrating pelvic endometriosis involving the sciatic nerve and pelvic wall.

Results 

The patient was treated by laparoscopic neurolysis of the involved somatic nerves according to the Possover operation.

Conclusions 

Endometriosis is a chronic inflammatory disease, potentially infiltrating the somatic nerves. Laparoscopic neurolysis is a therapeutic aetiological therapy, which can relieve neurological symptoms deriving from nerve infiltration/compression.