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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 contact@endobattery.com, or visiting the endobattery.com contact page.
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0:00
Life moves fast and so should the answers to your biggest questions. Welcome to EndoBattery's Quick Connect, your direct line to expert insights Short, powerful and right to the point. You send in the questions, I bring in the experts and in just five minutes you get the knowledge you need. No long episodes, no extra time needed, and just remember expert opinions shared here are for general information and not for personalized medical advice. Always consult your provider for your case-specific guidance. Got a question? Send it in and let's quickly get you the answers. I'm your host, alana, and it's time to connect.
Speaker 1:
0:41
Today's guest has built his career on a bold but vital belief that suffering pain should 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 in neuropelviology yes, you heard that right he has transformed how we understand and treat chronic pelvic pain, especially when the source is elusive or deemed untreatable. His work bridges the worlds of gynecology, neurology and minimally invasive surgery to target the pelvic nerve directly, often bringing relief to patients who've been told to simply live with it. His methods have given hope to countless people who have felt like they've run out of options. Please help me in welcoming Professor Marc Posobert. When should we be concerned for sciatic endometriosis?
Speaker 2:
1:30
To say I have cyclical pain. That means sciatic pain every month during men's bleeding. So it is an endometriosis. That is much too easy. But once a patient starts to develop some, too easy. But once a patient starts to develop some sensory disorder, with some numbness in the genitourinal area, in the lower back, in the buttock or in the sciatic nerve area and even more, but that is even more or less a 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 hope that you will know this pathology, because still a lot of colleagues don't know that endometriosis, sciatic nerve exists, may exist.
Speaker 1:
2:22
But it's not always sciatic nerve endometriosis. It can be just close to always sciatic nerve endometriosis. It can be just close to the sciatic nerve right.
Speaker 2:
2:27
The most frequent pathology that induce sciatic pain in the pelvis is a vascular entrapment, and that by far, and I completely agree. Endometriosis close to the sciatic nerve may induce also sciatic pain, but without neurological disorder. So then the treatment is to remove the endometriosis. Now if you have endometriosis of the sciatic nerve, these endometriosis grow within the sciatic nerve, and that is more tricky because you will have to resect the endometriosis out of the sciatic nerve, and that is really neurosurgery. So normally you have to act to react before the endometriosis start to grow within the sciatic nerve.
Speaker 1:
3:12
You would want someone that's specialized with endometriosis and neuropelviology probably to address that right. That's not something that someone common could probably do.
Speaker 2:
3:22
No, definitely to say I'm a high specialist in endometriosis, or endometriosis of the sciatic nerve belong to my gynecologist panoply. No, endometriosis of the sciatic nerve have nothing to do with gynecological surgery, except the name endometriosis. But that is really a moral surgery and one of the most dangerous and most difficult procedures within the pelvic cavity. It's not just for gynecology you have to be a neuropulmonary surgeon, and at least level three with a lot of experience.
Speaker 1:
3:59
Wow, I mean because that could impact your body and life significantly if it's not done right yeah.
Speaker 2:
4:06
Yeah, the problem if you do surgery on the sciatic nerve and you are not trained in this surgery and you are induced unnecessary damage of the sciatic nerve, patient will not need a wheelchair but she will not need crutches. She will get a foot drop for the rest of your life. So it's really something that is neurosurgery. It's not just oh, I suppose you have suspicion, or endometriosis, sciatic nerve, let's see. I will do a laparoscopy. I learned how to do that on cadaver dissection. I will go there and I will check. No, you have to have a clear roadmap and a clear diagnosis before you go in the OR.
Speaker 1:
4:44
Yes, it's the mapping aspect of endometriosis knowing before you get in.
Speaker 2:
4:50
You need a clear neuropelviological workup before you indicate any surgery on the pelvic nerves.
Speaker 1:
4:59
That's a wrap for this Quick Connect. I hope today's insights helped you move forward with more clarity and confidence. Do you have more questions? Keep them coming, send them in and I'll bring you the expert answers. You can send them in by using the link in the top of the description of this podcast episode or by emailing contact at endobatterycom or visiting the endobatterycom contact page. Until next time, keep feeling empowered through knowledge.