Marc Possover1, Nucelio Lemos. 1. Department of Surgical Gynecology & Neuropelveology, Hirslanden Clinic, Witellikerstrasse 40, 8032 Zürich, Switzerland. marc.possover@hirslanden.ch
Abstract
INTRODUCTION AND HYPOTHESIS: This study aims to report pelvic nerve damage secondary to surgical treatment of pelvic organ prolapse and the role of laparoscopy in the diagnosis and treatment of such nerve damage. METHODS: Ninety-five consecutive patients complaining of pain and/or bladder or bowel dysfunction following surgery for pelvic prolapse underwent laparoscopic exploration for pelvic neuropathy. RESULTS: A mean reduction in visual analog score (VAS) from 8.9 (± 0.96; 6-10) preoperatively to 2.9 (± 2.77; 0-6) at 1-year follow-up was obtained in patients after laparoscopic nerve decompression (n = 90; p < 0.001). Success, defined as a reduction in VAS score of greater than 50%, was obtained in 84% of patients. Sixty-five patients (68%) discontinued the regular use of analgesics. CONCLUSIONS: Because secondary nerve damage can appear months or years after the primary procedure, long-term follow-up is mandatory and should focus on nerve damage as well as anatomical and functional outcomes. Laparoscopy is a unique method for etiologic diagnosis and neurosurgical treatment of such nerve lesions through decompression or implantation of an electrode for neuromodulation.
INTRODUCTION AND HYPOTHESIS: This study aims to report pelvic nerve damage secondary to surgical treatment of pelvic organ prolapse and the role of laparoscopy in the diagnosis and treatment of such nerve damage. METHODS: Ninety-five consecutive patients complaining of pain and/or bladder or bowel dysfunction following surgery for pelvic prolapse underwent laparoscopic exploration for pelvic neuropathy. RESULTS: A mean reduction in visual analog score (VAS) from 8.9 (± 0.96; 6-10) preoperatively to 2.9 (± 2.77; 0-6) at 1-year follow-up was obtained in patients after laparoscopic nerve decompression (n = 90; p < 0.001). Success, defined as a reduction in VAS score of greater than 50%, was obtained in 84% of patients. Sixty-five patients (68%) discontinued the regular use of analgesics. CONCLUSIONS: Because secondary nerve damage can appear months or years after the primary procedure, long-term follow-up is mandatory and should focus on nerve damage as well as anatomical and functional outcomes. Laparoscopy is a unique method for etiologic diagnosis and neurosurgical treatment of such nerve lesions through decompression or implantation of an electrode for neuromodulation.
Authors: Cecilia K Wieslander; Shayzreen M Roshanravan; Clifford Y Wai; Joseph I Schaffer; Marlene M Corton Journal: Am J Obstet Gynecol Date: 2007-12 Impact factor: 8.661
Authors: Carly J McCarthy; Eugenia Tomasella; Mariana Malet; Kim B Seroogy; Tomas Hökfelt; Marcelo J Villar; G F Gebhart; Pablo R Brumovsky Journal: Brain Struct Funct Date: 2015-03-07 Impact factor: 3.270
Authors: Nucelio Lemos; Corey Sermer; Gustavo Fernandes; Augusta Morgado-Ribeiro; Andrea Rossos; Zi Ying Zhao; Manuel J B C Girão; Philip Peng Journal: Sci Rep Date: 2021-05-24 Impact factor: 4.379
Authors: Giuseppe Campagna; Lorenzo Vacca; Giovanni Panico; Giuseppe Vizzielli; Daniela Caramazza; Riccardo Zaccoletti; Monia Marturano; Roberta Granese; Martina Arcieri; Stefano Cianci; Giovanni Scambia; Alfredo Ercoli Journal: Front Med (Lausanne) Date: 2022-03-04