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

Ceccaroni, Marcello MD, PhD*,†; Clarizia, Roberto MD*,†,‡; Cosma, Stefano MD§; Pesci, Anna MD, PhD; Pontrelli, Giovanni MD; Minelli, Luca MD

Journal of Spinal Disorders & Techniques: October 2011 - Volume 24 - Issue 7 - p 474–478
doi: 10.1097/BSD.0b013e31820fc53b

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.

*Gynecologic Oncology Division, International School of Surgical Anatomy

Department of Obstetrics and Gynecology, European Gynaecology Endoscopy School, Negrar, Verona

Department of Obstetrics and Gynecological Sciences, University of Naples “Federico II”, Naples

§Department of Obstetrics and Gynecology, University of Turin, Turin

Department of Human Pathology, Sacred Heart Hospital, Negrar, Verona, Italy

The authors declare no conflict of interest.

Reprints: Marcello Ceccaroni, MD, PhD, Gynecologic Oncology Division, International School of Surgical Anatomy, Department of Obstetrics and Gynecology, European Gynaecology Endoscopy School, “Ospedale Sacro Cuore-Don Calabria”, Via Don A.Sempreboni no 5, 37024 Negrar, Verona, Italy (e-mail:

Received August 5, 2010

Accepted January 6, 2011

© 2011 Lippincott Williams & Wilkins, Inc.