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Nerve damage endometriosis

E S Ozyurek, T Yoldemir, U Kalkan
Endometriosis is classically defined as a chronic, recurrent and progressive disease. It is known to be estrogen-dependent, but can still be observed during the peri- and postmenopausal periods. Medical management of endometriosis is palliative symptomatic relief. Surgery when properly and timely performed for the right person may treat endometriosis. However, there is always a risk of possible major or minor surgical complications, as well as loss of some functions due to nerve damage. Management of endometriosis in the woman approaching the end of her reproductive life may require special attention both due to the potential for recurrence and transformation into various endometriosis-associated malignancies...
March 1, 2018: Climacteric: the Journal of the International Menopause Society
Samantha Brown, Lucas Rosa Fraga, Gary Cameron, Lynda Erskine, Neil Vargesson
Primodos was a hormone pregnancy test used between 1958-1978 that has been implicated with causing a range of birth defects ever since. Though Primodos is no longer used, it's components, Norethisterone acetate and Ethinyl estradiol, are used in other medications today including treatments for endometriosis and contraceptives. However, whether Primodos caused birth defects or not remains controversial, and has been little investigated. Here we used the developing zebrafish embryo, a human cell-line and mouse retinal explants to investigate the actions of the components of Primodos upon embryonic and tissue development...
February 13, 2018: Scientific Reports
Marielly Cuevas, Myrella L Cruz, Antonio E Ramirez, Idhaliz Flores, Kenira J Thompson, Manuel Bayona, Michael W Vernon, Caroline B Appleyard
PURPOSE: We have previously shown that stress prior to induction worsens clinical presentation and inflammatory parameters in a rat model of endometriosis. This study was designed to examine whether stress during the development of endometriosis can affect the growth of endometriotic implants through nerve growth and immune alterations. METHODS: Endometriosis was surgically induced in female Sprague-Dawley rats by suturing uterine horn implants onto the small intestine mesentery...
March 2018: Reproductive Sciences
M Fermaut, K Nyangoh Timoh, C Lebacle, D Moszkowicz, G Benoit, T Bessede
OBJECTIVES: Deep pelvic endometriosis surgery may need substantial excisions, which in turn expose to risks of injury to the pelvic nerves. To limit functional complications, nerve-sparing surgical techniques have been developed but should be adapted to the specific multifocal character of endometriotic lesions. The objective was to identify the anatomical areas where the pelvic nerves are most at risk of injury during endometriotic excisions. METHODS: The Medline and Embase databases have been searched for available literature using the keywords "hypogastric nerve or hypogastric plexus [Mesh] or autonomic pathway [Mesh], anatomy, endometriosis, surgery [Mesh]"...
May 2016: Gynécologie, Obstétrique & Fertilité
S Chen, W Xie, J A Strong, J Jiang, J-M Zhang
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...
August 2016: European Journal of Pain: EJP
L Campin, B Borghese, L Marcellin, P Santulli, A Bourret, C Chapron
Lower urinary tract disorders in case of deep endometriosis are common (up to 50% of patients), although often masked by pelvic pain. They result from damage to the pelvic autonomic nervous system by direct infiltration of these structures by endometriotic lesions or surgical trauma (especially in resection of the uterosacral ligaments, rectum or vagina). These are mainly sensory disturbances and bladder voiding dysfunction. They impact quality of life and could be responsible for long-term complications (recurrent urinary tract infections on a persistent residual urine or pelvic floor disorders due to chronic thrusting)...
June 2014: Journal de Gynécologie, Obstétrique et Biologie de la Reproduction
Müge Harma, Görker Sel, Bektaş Açıkgöz, Mehmet İbrahim Harma
INTRODUCTION: Intraoperative injury of obturator nerve is a rare complication of gynecologic surgeries, it has been reported especially in patients with endometriosis and genitourinary malignancies. Gynecologic patients undergoing open lymphadenectomy are at increased risk of obturator nerve injury. PRESENTATION OF CASE: A 60-year-old woman with FIGO stage II Grade II endometrial adenocarcinoma underwent bilateral pelvic paraaortic lymphadenectomy. During right obturator lymph node dissection, the right obturator nerve was inadvertently transected with Harmonic scalpel sealing system...
2014: International Journal of Surgery Case Reports
S Rimbach, U Ulrich, K W Schweppe
Endometriosis is one of the most common disorders encountered in surgical gynaecology. The laparoscopic technique, the planning of the surgical intervention, the extent of information provided to patients and the interdisciplinary coordination make it a challenging intervention. Complete resection of all visible foci of disease offers the best control of symptoms. However, the possibility of achieving this goal is limited by the difficulty of detecting all foci and the risks associated with radical surgical strategies...
September 2013: Geburtshilfe und Frauenheilkunde
A Kavallaris, I Mebes, D Evagyelinos, A Dafopoulos, D A Beyer
PURPOSE: The radical surgery of the deep infiltrating endometriosis of the rectovaginal septum and the uterosacral ligaments with or without bowel resection can cause a serious damage of the pelvic autonomic nerves with urinary retention and the need of self-catheterization. Major goal of this review article is to compare different surgical techniques of deep infiltrating endometriosis and their follow-up results. METHODS: The research strategy included the online search of databases [MEDLINE, EMBASE, SCOPUS] for the diagnosis of deep infiltrating endometriosis with the indication of an operative resection...
May 2011: Archives of Gynecology and Obstetrics
A Graziottin
Pain is a complex subjective experience, associated with neurovegetative, affective and cognitive rapid changes. Biological, psychosocial and contextual factors may contribute. Chronic inflammation, of whatever cause, is the leading contributor to chronic pain. The mast cell directs both the inflammatory process and the shift to chronic pain, mediating through the production of Nerve Growth Factor (NGF) and other neurotrophic molecules. Women, in the fertile age, are biologically more vulnerable to chronic inflammation, as fluctuations of estrogens are agonist factors of mast cells degranulation, mostly in the premenstrual phase...
April 2008: Urologia
A Kavallaris, C Banz, N Chalvatzas, A Hornemann, D Luedders, K Diedrich, M Bohlmann
INTRODUCTION: The radical surgery of the deep infiltrating endometriosis of the rectovaginal septum and the uterosacral ligaments with or without bowel resection can cause a serious damage of the pelvic autonomic nerves with urinary retention and the need of self-catheterization. PATIENTS AND METHODS: We introduce a case series report of 16 patients with laparoscopic nerve-sparing surgery of deep infiltrating endometriosis. We describe the technique step by step and compare the patients' outcome with patients who had undergone a non-nerve-sparing surgical technique...
July 2011: Archives of Gynecology and Obstetrics
Mirko Pham, Claudia Sommer, Carsten Wessig, Camelia-Maria Monoranu, José Pérez, Guido Stoll, Martin Bendszus
OBJECTIVE: To illustrate magnetic resonance neurography findings of severe sciatic injury and muscle denervation related to deep gluteal endometriosis at the sciatic notch. DESIGN: Case report. SETTING: Academic teaching hospital. PATIENT(S): A 39-year-old woman with a 4-year history of sciatica related to the menstrual cycle. INTERVENTION(S): Surgical exploration of the sciatic notch for diagnostic confirmation, external neurolysis of the sciatic nerve, and eventual pharmacologic treatment...
June 2010: Fertility and Sterility
Marc Possover
PURPOSE: The feasibility of the laparoscopic transperitoneal approach to the pelvic somatic nerves was determined for the diagnosis and treatment of anogenital pain caused by pudendal and/or sacral nerve root lesions. MATERIALS AND METHODS: The records of 134 consecutive patients who underwent laparoscopy for refractory anogenital pain were retrospectively reviewed. All neurosurgical procedures, such as neurolysis/decompression of the pudendal nerve and the sacral nerve roots or neuroelectrode implantation to the sacral plexus for postoperative neuromodulation, were done via the laparoscopic transperitoneal approach to the pelvic nerves...
April 2009: Journal of Urology
K Mannan, F Altaf, S Maniar, R Tirabosco, M Sinisi, T Carlstedt
We describe a case of sciatic endometriosis in a 25-year-old woman diagnosed by MRI and histology with no evidence of intrapelvic disease. The presentation, diagnosis and management of this rare condition are described. Early diagnosis and treatment are important to prevent irreversible damage to the sciatic nerve.
January 2008: Journal of Bone and Joint Surgery. British Volume
X Deffieux, P Raibaut, K Hubeaux, S Sheikh Ismael, G Amarenco
Autonomic nerve (sympathic and parasympathic) damage plays a crucial role in the aetiology of bladder dysfunction that occurs after resection of deeply infiltrating endometriosis (uterosacral ligaments, colorectal bowel, rectovaginal wall). This review presents an overview of the pathophysiology and management of voiding dysfunction that occur after this kind of surgery. The rate of significant post-voiding residual volume and/or hypoactive bladder after colorectal resection for endometriosis ranges from 15 to 20%...
April 2007: Gynécologie, Obstétrique & Fertilité
A Hettler, J Böhm, M Pretzsch, G von Salis-Soglio
We report on a 44-year-old woman with a history of sciatica fluctuating with her menstrual cycle and going back over 10 years; ultimately it was present continuously and became disabling. Over the years the patient developed ipsilateral foot-drop, a sensory disorder in the lateral aspect of the lower limb and back of the foot, and atrophy of the gluteus muscle. MRI confirmed the suspicion of extragenital endometriosis, which had caused piriformis syndrome by compression with consequent damage to the sciatic and inferior gluteal nerves...
April 2006: Der Nervenarzt
Martin Quinn
Endometriosis describes endometrium found outside the uterine cavity and is frequently associated with clinical presentations of chronic pelvic pain, dysmenorrhoea, dyspareunia and subfertility. It was originally attributed to retrograde menstruation with endometrium passing in a reverse direction along the Fallopian tubes into the peritoneal cavity though this theory does not account for the spectrum of intrapelvic findings. Denervation followed by reinnervation in the uterine isthmus is proposed as the primary source of clinical symptoms, and, retrograde menstruation with adhesion of endometrium to injured tissue surfaces the variable laparoscopic findings...
2004: Medical Hypotheses
L Fedele, S Bianchi, R Raffaelli, G Zanconato, G Zanette
OBJECTIVE: To assess the efficacy and diagnostic value of GnRH agonist (GnRH-a) therapy in cases of hidden sciatic nerve endometriosis. DESIGN: Case report. SETTING: Academic tertiary referral center for endometriosis treatment. PATIENT(S): Three patients with cyclic, catamenial sciatica associated with pelvic endometriosis who had electromyographic evidence of sciatic nerve damage but negative computed tomography and magnetic resonance imaging findings...
October 1999: Fertility and Sterility
J M Vasquez, E Eisenberg, K G Osteen, D Hickerson, M P Diamond
Surgical modalities such as electrosurgery and lasers have been used for many years to treat endometriosis. They are relatively unselective with wide scatter, however, leading to the potential for significant tissue damage and injury. As an alternative, a technique for performing laparoscopic excision and adhesiolysis using a cavitational ultrasonic surgical aspirator (CUSA) was developed and studied in 15 patients. Endometriosis was removed using a prototype titanium probe developed for a 10-mm laparoscopic port...
November 1993: Journal of the American Association of Gynecologic Laparoscopists
R Dhôte, L Tudoret, C Bachmeyer, P Legmann, B Christoforov
STUDY DESIGN: A case of cyclic sciatica secondary to ovarian cyst endometriosis is presented. OBJECTIVES: To report the clinical description and magnetic resonance imaging aspects of cyclic sciatica. SUMMARY OF BACKGROUND DATA: Endometriosis of the sciatic nerve is rare, but must be included in the differential diagnosis of sciatic mononeuropathies. METHODS: The authors report a new case of a woman whose cyclic sciatica was caused by an ovarian cystic endometriosis lesion...
October 1, 1996: Spine
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