Laparoscopic therapy for endometriosis and vascular entrapment of sacral plexus

Possover, Marc; Schneider, Thilo; Henle, Klaus-Peter

doi:10.1016/j.fertnstert.2010.08.048

Cited by 83 publications

(39 citation statements)

References 19 publications

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“…The model may shed light on the relatively rare condition of isolated sciatic endometriosis which has been described primarily in case reports(Baker et al, 1966; Cottier et al, 1995; Floyd et al, 2011; Papapietro et al, 2002; Pham et al, 2010; Vercellini et al, 2003). In addition, the model may be relevant for more common cases of endometriosis in the abdomino-pelvic cavity directly affecting nerves (including the sciatic, pudendal, obturator and femoral) or their spinal roots, often in conjunction with other sites (Ceccaroni et al, 2010a; Ceccaroni et al, 2011; Ceccaroni et al, 2010b; Lemos et al, 2012; Possover, 2009; Possover et al, 2007; Possover and Chiantera, 2007; Possover et al, 2011; Waer et al, 2012; Zager et al, 1998). In particular, deep infiltrating endometriosis, observed in 1/3 of laparoscopies performed to investigate severe pelvic pain, has been shown to be associated with intraneurial and perineurial invasion and nerve encapsulation; greater nerve involvement correlated with higher pain levels (Anaf et al, 2000; Ceccaroni et al, 2012; Fraser, 2010; Morotti et al, 2014; Wang et al, 2009).…”

Section: Discussionmentioning

confidence: 99%

“…In patients with deep infiltrating endometriosis of the sigmoid and rectum, over 50% of lesions were in direct contact with nerves; it was proposed that ectopic endometrium infiltrated the bowel wall preferentially along nerves (Anaf et al, 2004). In women referred for sacral radiculopathy of unknown origin, endometriosis affecting pelvic nerves was found to be the cause in 82% (Possover et al, 2011). Thus, understanding the interactions between ectopic endometrium and adjacent nerves may shed light on some of the most painful and intractable manifestations of endometriosis.…”

Section: Discussionmentioning

confidence: 99%

“…Conversely, in women referred for sacral radiculopathy of nonspinal origin, endometriosis was the most common cause (Possover et al, 2011). Clinical case reports show that sciatica can be caused by endometriosis of the sciatic nerve, often fluctuating with the menstrual cycle (Dhote et al, 1996; Head et al, 1962; Papapietro et al, 2002; Torkelson et al, 1988; Vaisberg, 1964).…”

Section: Introductionmentioning

confidence: 99%

“…Leg pain including sciatica is significantly more common in endometriosis patients, with an incidence of 50% (Missmer and Bove, 2011;Walch et al, 2014). Conversely, in women referred for sacral radiculopathy of nonspinal origin, endometriosis was the most common cause (Possover et al, 2011). Clinical case reports show that sciatica can be caused by endometriosis of the sciatic nerve, often fluctuating with the menstrual cycle (Head et al, 1962;Vaisberg, 1964;Torkelson et al, 1988;Dhote et al, 1996;Papapietro et al, 2002).…”

Section: Introductionmentioning

confidence: 99%

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Sciatic endometriosis induces mechanical hypersensitivity, segmental nerve damage, and robust local inflammation in rats

Chen

Xie

Strong

et al. 2015

European Journal of Pain

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Background Endometriosis is a common cause of pain including radicular pain. Ectopic endometrial tissue may directly affect peripheral nerves including the sciatic, which has not been modelled in animals. Methods We developed a rat model for sciatic endometriosis by grafting a piece of autologous uterine tissue around the sciatic nerve. Control animals underwent a similar surgery but received a graft of pelvic fat tissue. Results The uterine grafts survived and developed fluid filled cysts; the adjacent nerve showed signs of swelling and damage. Mechanical and cold hypersensitivity and allodynia of the ipsilateral hindpaw developed gradually over the first two weeks after the surgery, peaked at 2 to 5 weeks, and was almost resolved by 7 weeks. Control animals showed only minor changes in these pain behaviors. Histological signs of inflammation in the uterine graft and in the adjacent nerve were observed at 3 weeks but were resolving by 7 weeks. In vivo fiber recording showed increased spontaneous activity, especially of C fibers, in sciatic nerve proximal to the uterine graft. Several pro-inflammatory cytokines including interluekin-18, VEGF, fractalkine, and MIP-1α, were elevated in the uterine graft plus sciatic nerve samples, compared to samples from normal nerve or nerve plus fat graft. Growth associated protein 43 (GAP43), a marker of regenerating nerve fibers, was observed in the adjacent sciatic nerve as well as in the uterine graft. Conclusions This model shared many features with other rat models of endometriosis, but also had some unique features more closely related to neuropathic pain models.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Sciatic endometriosis induces mechanical hypersensitivity, segmental nerve damage, and robust local inflammation in rats

Chen

Xie

Strong

et al. 2015

European Journal of Pain

View full text Add to dashboard Cite

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“…It is long known that a large portion of the lumbosacral plexus is located intra-abdominally, in the retroperitoneal space [ 1 ]. However, most of literature descriptions of lesions on this plexus refer to its extra-abdominal parts whereas its intra-abdominal portions are often neglected [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic approach to intrapelvic nerve entrapments

Lemos

Possover

2015

Journal of Hip Preservation Surgery

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It is long known that a large portion of the lumbosacral plexus is located intra-abdominally, in the retroperitoneal space. However, most of literature descriptions of lesions on this plexus refer to its extra-abdominal parts whereas its intra-abdominal portions are often neglected. The objective of this review article is to describe the laparoscopic anatomy of intrapelvic nerve bundles, as well as the findings and advances already achieved by Neuropelveology practitioners.

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Neural involvement in endometriosis: Review of anatomic distribution and mechanisms

et al. 2015

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Endometriosis (EM) is an infrequent cause of peripheral neuropathy, most commonly sciatic. Perineural spread has recently been introduced as an alternate explanation for cases of lumbosacral or sciatic nerve EM. We performed a literature review to collect all reported cases of peripheral and central nervous system EM in search of anatomic patterns of involvement; potentially to support the perineural spread theory. If available, intraneural invasion and presence of peritoneal EM were recorded. The search revealed 83 articles describing 365 cases of somatic peripheral nervous EM and 13 cases of central nervous EM. The most frequently involved site was the sacral plexus (57%, n = 211), followed by the sciatic nerve (39%, n = 140). Other nerves were reported in significantly smaller numbers. Ninety seven percent (97%, n = 355) of peripheral nerve cases presented with pain, 20% (n = 72) reported weakness and 31% (n = 114), numbness. Thirty four percent (34%, n = 38) had solely intraneural EM of which 89% (n = 33) had no peritoneal EM (percentage based on available information). In the central nervous system, the conus medullaris and/or cauda equina constituted the majority of cases with 54% (n = 7). Apart from perineural spread, other discussed mechanisms include retrograde menstruation with peritoneal seeding, hematogenous and lymphogenous spread, stem cell implantation either hematogenously or via retrograde menstruation with subsequent EM differentiation, and coelomic or Müllerian duct metaplasia. We believe this literature review supports perineural spread as an alternate mechanism for EM of nerve, particularly the subgroup with intraneural EM and without peritoneal disease.

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Laparoscopic therapy for endometriosis and vascular entrapment of sacral plexus

Cited by 83 publications

References 19 publications

Sciatic endometriosis induces mechanical hypersensitivity, segmental nerve damage, and robust local inflammation in rats

Sciatic endometriosis induces mechanical hypersensitivity, segmental nerve damage, and robust local inflammation in rats

Laparoscopic approach to intrapelvic nerve entrapments

Neural involvement in endometriosis: Review of anatomic distribution and mechanisms

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