Cyclic Sciatica in a Patient With Deep Monolateral Endometriosis Infiltrating the Right Sciatic Nerve

STUDY DESIGN: Case report. OBJECTIVE: To show by case presentation, the potential for endometriosis to infiltrate the somatic nerves causing lower extremity neuropathic pain and to discuss possible surgical remedy and the effectiveness of laparoscopic neurolysis. SUMMARY OF BACKGROUND DATA: Pelvic endometriosis may infiltrate the pelvic wall and somatic nerves causing severe neuropathic symptoms. METHODS: We report a case of a 41-year-old woman with a history of severe dysmenorrhea, dyspareunia, and chronic pelvic pain with concomitant monolateral right sciatica because of deep infiltrating pelvic endometriosis involving the sciatic nerve and pelvic wall. RESULTS: The patient was treated by laparoscopic neurolysis of the involved somatic nerves according to the Possover operation. CONCLUSIONS: Endometriosis is a chronic inflammatory disease, potentially infiltrating the somatic nerves. Laparoscopic neurolysis is a therapeutic aetiological therapy, which can relieve neurological symptoms deriving from nerve infiltration/compression.