Endometriosis of the pelvic nerves can be divided into endometriosis of the vegetative nervous system and endometriosis of the somatic nervous system.
Endometriosis of the nervous system can be found on or near nervous structures, and of course, in the genital and extragenital organs.
The vegetative nervous system automatically ensures the functions of organs such as the heart, liver, lungs, bladder, stomach and consists of:
- Sympathetic nervous system;
- Parasympathetic nervous system;
The somatic nervous system consists of sensory and motor nerves and has the role of transmitting signals from the brain to the target organs, being involved in the voluntary control of body movements.
The somatic nerves that can be affected by pelvic endometriosis are: the sciatic nerve, the pudendal nerve, the obturator nerve and the femoral nerve.
When deep infiltrating endometriosis affects organs and nodules at the level of the utero-sacral ligaments, deeply infiltrating the parameter and/or the paracolpium (the tissue surrounding the vagina), it will cause pain during sexual intercourse, pain during bowel movements, pain felt in the paravertebral region, radiating to the thigh.
Endometriosis of the sacral plexus occurs most frequently on the left side. Sciatic endometriosis is the growth of endometriotic tissue around the sciatic nerve and as a result this tissue puts pressure on the nerve.
What is neruropelvelogy?
Neuropelveology is a discipline founded by Prof. Possover, used for the diagnosis of injuries and dysfunctions of the pelvic nerves. Neuropelveology is used for endometriosis of the pelvic nerves.
Neuropelevology is divided into two types of surgeries:
- Laparoscopy of the pelvic nerves.
- The LION procedure.
Laparoscopy of the pelvic nerves is a nerve-sparing surgery in order to preserve the function of the bladder, intestines and sexual organs.
LION procedure (Laparoscopic implantation of neuroprothesis) uses neuromodulation to treat the affected nerves. It is the world’s first technique to allow the selective placement of electrodes on certain pelvic nerves in order to stimulate them electrically (Possover, n.d).