A case of laparoscopic surgery for endometriosis in a patient with sciatica

The causes of sciatica are diverse and difficult to diagnose in orthopedic practice. In gynecological diseases, uterine myoma and endometriosis are often cited as differentials, but many gynecologists are not aware of their relationship to sciatic neuralgia. We report a case in which laparoscopic surgery was effective in treating sciatic neuralgia, which was difficult to diagnose by orthopedic surgeons. A 46-year-old woman, gravida 2 para 2, complained of low back pain and sensory disturbance in the right lower extremity, but there was no orthopedic abnormality. Pelvic MRI revealed endometriotic cysts in the bilateral ovaries, and laparoscopic surgery was performed to remove the endometriotic lesions, which resulted in the disappearance of pain. Pelvic endometriosis can be involved in sciatic neuralgia. It is important to collaborate with an orthopedic surgeon to make a systematic diagnosis and pain assessment, and to determine a treatment plan.