Vascular entrapment of the sciatic plexus causing catamenial sciatica and urinary symptoms
Nucelio Lemos1, Renato Moretti Marques2, Gil Kamergorodsky2
1Pelvic Neurodysfunction Clinic of the Department of Obstetrics and Gynecology, Federal University of São Paulo, Rua Jose de Magalhaes, 373 ap904., São Paulo, SP, CEP: 04026-090, Brazil. nucelio@gmail.com.
International Urogynecology Journal
|July 27, 2015
Summary
Vascular compression of sacral plexus nerves can cause pelvic pain, sciatica, and urinary dysfunction. Laparoscopic decompression offers effective relief for these debilitating symptoms.
Area of Science:
- Vascular Surgery
- Neurology
- Gynecology
Background:
- Pelvic congestion syndrome is a known cause of cyclic pelvic pain.
- Dilated iliac vessels can entrap sacral plexus nerves, causing sciatica and refractory urinary/anorectal dysfunction.
Observation:
- This video reviews intrapelvic vascular entrapment of the sacral plexus.
- It demonstrates laparoscopic decompression of nerves entrapped by vessels.
Findings:
- Laparoscopic decompression led to full recovery from sciatica and resolution of sacral nerve root entrapment symptoms.
- Partial recovery of myofascial pain was observed in one patient.
Implications:
- Symptoms like perineal pain, radiating lower limb pain, or urinary dysfunction without spinal/bladder issues suggest nerve entrapment.
- Radiologists should use specific MRI sequences, and surgical teams should be prepared for nerve decompression.
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