QC: Sciatic Endometriosis: When to Worry

Send us a text with a question or thought on this episode ( We cannot replay from this link)

Professor Marc Possover, world-renowned pioneer in neuropelviology, discusses when and why to be concerned about sciatic endometriosis. He explains the critical distinction between regular endometriosis near the sciatic nerve versus endometriosis growing within the nerve itself, which requires specialized neurosurgical intervention.

• Cyclical sciatic pain during menstruation may suggest endometriosis involvement
• Sensory disorders, numbness, and weakness are serious warning signs requiring immediate attention
• Vascular entrapment is the most common cause of sciatic pain in the pelvis
• Endometriosis of the sciatic nerve requires specifically trained neuropelviological surgeons, not just gynecologists
• Improper surgery on the sciatic nerve can cause permanent disability like foot drop
• A comprehensive neuropelviological workup is essential before any surgical intervention
• True sciatic nerve endometriosis surgery is among the most difficult and dangerous pelvic procedures

Do you have more questions? Send them in by using the link in the top of the description, emailing [e-mail], or visiting the endobattery.com contact page.

Support the show

Website endobattery.com

Episode Transcript

Speaker 1 (00:00):
Life moves fast and so should the answers to your
biggest questions.
Welcome to EndoBattery's QuickConnect, your direct line to
expert insights Short, powerfuland right to the point.
You send in the questions, Ibring in the experts and in just
five minutes you get theknowledge you need.
No long episodes, no extra timeneeded, and just remember

(00:20):
expert opinions shared here arefor general information and not
for personalized medical advice.
Always consult your providerfor your case-specific guidance.
Got a question?
Send it in and let's quicklyget you the answers.
I'm your host, alana, and it'stime to connect.

(00:41):
Today's guest has built hiscareer on a bold but vital
belief that suffering painshould not be a life sentence.
And for Professor Mark Possover, that belief isn't just a
philosophy, it's a mission.
As a world-renowned pioneer inneuropelviology yes, you heard
that right he has transformedhow we understand and treat
chronic pelvic pain, especiallywhen the source is elusive or

(01:05):
deemed untreatable.
His work bridges the worlds ofgynecology, neurology and
minimally invasive surgery totarget the pelvic nerve directly
, often bringing relief topatients who've been told to
simply live with it.
His methods have given hope tocountless people who have felt
like they've run out of options.
Please help me in welcomingProfessor Marc Posobert.

(01:26):
When should we be concerned forsciatic endometriosis?

Speaker 2 (01:30):
To say I have cyclical pain.
That means sciatic pain everymonth during men's bleeding.
So it is an endometriosis.
That is much too easy.
But once a patient starts todevelop some, too easy.
But once a patient starts todevelop some sensory disorder,

(01:50):
with some numbness in thegenitourinal area, in the lower
back, in the buttock or in thesciatic nerve area and even more
, but that is even more or lessa late diagnosis, when patients
are starting to develop weakness, with foot drop, for example,
or difficulty for contraction,flexion of the toes, then the
next appointment, the next door,is a gynecologist, with the

(02:13):
hope that you will know thispathology, because still a lot
of colleagues don't know thatendometriosis, sciatic nerve
exists, may exist.

Speaker 1 (02:22):
But it's not always sciatic nerve endometriosis.
It can be just close to alwayssciatic nerve endometriosis.
It can be just close to thesciatic nerve right.

Speaker 2 (02:27):
The most frequent pathology that induce sciatic
pain in the pelvis is a vascularentrapment, and that by far,
and I completely agree.
Endometriosis close to thesciatic nerve may induce also
sciatic pain, but withoutneurological disorder.
So then the treatment is toremove the endometriosis.

(02:48):
Now if you have endometriosisof the sciatic nerve, these
endometriosis grow within thesciatic nerve, and that is more
tricky because you will have toresect the endometriosis out of
the sciatic nerve, and that isreally neurosurgery.
So normally you have to act toreact before the endometriosis

(03:09):
start to grow within the sciaticnerve.

Speaker 1 (03:12):
You would want someone that's specialized with
endometriosis andneuropelviology probably to
address that right.
That's not something thatsomeone common could probably do
.

Speaker 2 (03:22):
No, definitely to say I'm a high specialist in
endometriosis, or endometriosisof the sciatic nerve belong to
my gynecologist panoply.
No, endometriosis of thesciatic nerve have nothing to do
with gynecological surgery,except the name endometriosis.
But that is really a moralsurgery and one of the most

(03:45):
dangerous and most difficultprocedures within the pelvic
cavity.
It's not just for gynecologyyou have to be a neuropulmonary
surgeon, and at least levelthree with a lot of experience.

Speaker 1 (03:59):
Wow, I mean because that could impact your body and
life significantly if it's notdone right yeah.

Speaker 2 (04:06):
Yeah, the problem if you do surgery on the sciatic
nerve and you are not trained inthis surgery and you are
induced unnecessary damage ofthe sciatic nerve, patient will
not need a wheelchair but shewill not need crutches.
She will get a foot drop forthe rest of your life.
So it's really something thatis neurosurgery.
It's not just oh, I suppose youhave suspicion, or

(04:29):
endometriosis, sciatic nerve,let's see.
I will do a laparoscopy.
I learned how to do that oncadaver dissection.
I will go there and I willcheck.
No, you have to have a clearroadmap and a clear diagnosis
before you go in the OR.

Speaker 1 (04:44):
Yes, it's the mapping aspect of endometriosis knowing
before you get in.

Speaker 2 (04:50):
You need a clear neuropelviological workup before
you indicate any surgery on thepelvic nerves.

Speaker 1 (04:59):
That's a wrap for this Quick Connect.
I hope today's insights helpedyou move forward with more
clarity and confidence.
Do you have more questions?
Keep them coming, send them inand I'll bring you the expert
answers.
You can send them in by usingthe link in the top of the
description of this podcastepisode or by emailing contact
at endobatterycom or visitingthe endobatterycom contact page.

(05:23):
Until next time, keep feelingempowered through knowledge.