Retroperitoneoscopic lumbar sympathectomy for plantar hyperhidrosis

Area of Science:

• Urology
• Surgical Innovation
• Patient Outcomes

Background:

• Primary plantar hyperhidrosis (PPH) significantly impacts quality of life (QoL).
• Surgical interventions aim to alleviate PPH symptoms and improve patient well-being.
• Retroperitoneoscopic lumbar sympathectomy (RLS) is a minimally invasive option for PPH treatment.

Purpose of the Study:

• To assess QoL changes in PPH patients post-RLS.
• To evaluate patient satisfaction with RLS for PPH.
• To describe the efficacy, safety, and procedural aspects of bilateral RLS.

Main Methods:

• Longitudinal study of consecutive severe PPH patients (October 2005-October 2014).
• Patients completed pre-operative symptom reporting and post-RLS QoL questionnaires (≥12 months).
• Evaluated disease outcomes, symptom recurrence, and adverse effects at 30 days and ≥12 months post-RLS.

Main Results:

• PPH resolved in all patients (116 procedures, 58 patients) at 30 days.
• Transient thigh neuralgia (5.2%) and lower limb paresthesia (32.7%) were reported.
• 98% of patients reported improved QoL, with mild-to-moderate compensatory sweating in ~50% but no regret.

Conclusions:

• Bilateral RLS is a safe and effective treatment for severe PPH in both sexes.
• RLS leads to significant QoL improvement without major adverse events like retrograde ejaculation.
• High patient satisfaction is achieved due to effective PPH symptom resolution, despite manageable compensatory sweating.