Hello Ocaders
Hope you all have been well.
We have been getting a few requests from the OB docs to evaluate the
hypogastric plexus in patients with deep endometriosis. We have been able
to evaluate the sacral plexus very well in our neurography studies
including the pudendal nerve at the Alcock’s canal but the hypogastric
plexus is a very small weblike network of fibers located deep in the
parametrium. I can infer based on the location of the implant but direct
evaluation has been challenging.
any tips, tricksand insights from the experts would be very welcome.
cheers
Lucas
Many thanks for the prompt reply.
Looks like this a hot topic for quite a few people. Got a few questions
inquiring about protocol and evaluation of specific nerves like ii, ih and
pudendal nerves.
I leave below Dr Chabbra´s response that answers many questions made by
some members. He also sent really nice images with surgical correlation. If
anyone is interested please let me know.
*”Yes- we do blocks of superior hypogastric plexus (L5-S1 level) and
sympathetic blocks (T12-L1) or ganglion impar block (at S_C junction) as
needed under CT guidance.*
*With deep endometriosis- common findings in my experience are-*
– *focal hemorrhagic lesions at sciatic notch, uterosacral lig, bladder
anterior wall apart from chocolate cysts*
– *multiple neuropathies- LFCN, Iliohypo, Ilioing, etc*
– *cyclical sciatica with sciatic neuropathy”*
best
Lucas
Em qua., 20 de abr. de 2022 às 22:12, Lucas Da Gama Lobo < gamalobolucas@gmail.com> escreveu: