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Nerve damage caused by endometriosis

Some of the most painful endometriosis lesions are those that invade the pelvic nerves.
For example, endometriosis of the pudendal nerve (PN) can cause severe neuralgia (nerve pain) in those places that are innervated by this nerve, such as the anus, labia, perineum, rectum, vaginal area, and urethra, just to name a few. However, the pain may radiate beyond these areas.  Reported symptoms include stabbing pain, numbness, bowel symptoms, and painful intercourse. Endometriosis of the PN is often mistaken for other conditions, such as pelvic floor disorders, interstitial cystitis, and musculoskeletal disorders.

Endometriosis that affects the obturator nerve, which crosses through the pelvic region and innervates the inner thighs, can cause pain that radiates down the leg or toward the groin area or hips. Another way that endometriosis can cause leg pain is when it affects the pudendal nerve, which innervates the lower vagina and external female genitalia. As with the obturator nerve, any areas connected to the pudendal nerve can become painful due to the endometriotic lesions. Endometriosis has also been found traveling along the obturator nerve to the adductor compartment of the thigh (P Waer, et al, Japan Journal of Radiology, 2012), which can cause pain in the hips and thighs.

Advanced surgical techniques needed to treat endometriosis of the nerves
Because the nerves cannot safely sustain traditional excision surgery, an entirely different technique is required to remove the endometriotic lesions. There are only a handful of surgeons in the world with the advanced skills needed to perform these extremely complex surgeries. Not only is Dr. Nezhat among the few capable of performing such extremely difficult surgeries, he’s also the one who pioneered these advanced techniques using minimally invasive methods.