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Best thanks for your remark. If you affected by an infiltrating endometriosis of the sciatic nerve, you may not wait 2 years. Endometriosis of the SN is able to destroy your nerve and this in less than 2 years, and no any hormonal treatment will be able to cure the disease. Endometriosis will not kill you, but can kill your nerve and for this reason - if you are affected by such a condition, you have to have the surgery before irreversible nerve damages may occurred. See following links: Laparoscopic morphological aspects and tentative explanation of the aetiopathogenesis of isolated endometriosis of the sciatic nerve: a review based on 267 patients. Possover M. Facts Views Vis Obgyn. 2021 Dec;13(4):369-375. doi: 10.52054/FVVO.13.4.047. PMID: 35026098 and Five-Year Follow-Up After Laparoscopic Large Nerve Resection for Deep Infiltrating Sciatic Nerve Endometriosis. Possover M. J Minim Invasive Gynecol. 2017 Jul-Aug;24(5):822-826. doi: 10.1016/j.jmig.2017.02.027. Epub 2017 Apr 23. PMID: 28445777 Amities M. Possover

Thank you too for your interest in this very important topic 🤔

Thank you m ydear Friend Porf. Dogyun - tghe 1st certified neuropelveologe in south-korea! ;-))

Best thanks for your question. Yes inguinal endometriosis can also cause leg pain when it affects the genitofemoral nerve. It's a completely different pain from sciatic pain, but it radiates also down ino the leg. For your second question: I know that some gynecologist want to start in neuropelveology with the endometriosis of the sciatic nerve, but that is really not a good idea for two reason: 1. in some case, endometriosis has already destroyed part of the sciatic nerve. This part must be resected out of the nerve to avoid recurence. 2. The surgery of endometriosis of the sciatic is one of the most difficult pelvic surgery with a very high risk for a life threatening bleeding. So this surgery definitively requires mor than only experience in gynecological surgery, but also in vascular surgery. When I was a cardivascular surgeon for 25 years, I rember of emergy situations in which as a vascular surgeon we had to save patients because of such bleeding in gynecology and urology. To be a good surgeon does mean only to have good hands and high skill, but also the capability of managing complications and more thank that to be abble to avoid complication. SCiatic nerve endometriosis belong to high experienced neuropelveologist Level 3. Now for your last question - how long does such a surgey last: such a surgery takes the time it's required - in my hand I need usually between 2 and 3 hours. Amities. ☺

Thank you very much for such an informative reply!!! Who knows, maybe I will be one of your patients for a surgery. Have a wonderful day

I completely agree and that the main reason why I have 3 professorship...teaching and education is the key in medicine!

thanks, it's my pleasure since education is the ley in medicine

Yes definitely

@@prmarcpossover that’s very interesting! My wife has adenomyosis and suspected endometriosis and over the years she has become more and more sensitive to perfume, chemicals, additives, foods, more allergies in general, etc

Glad you liked it!

Thanks

You are welcome

Thanks 😊

I am so sorry, what is SEO😁😆

@@prmarcpossover Video SEO stands for Search Engine Optimization, which helps your videos rank higher in RUclips search results. With proper SEO, your videos can reach a larger audience and gain more organic views, subscribers, and engagement in the long run. I can assist you in developing the right SEO strategy for your videos so that you can grow better on RUclips. If you're curious, we can discuss this in more detail. 😊

Thank you so much for kind encouraging words 😘

I compeltely agree with you and in my consultation aroung 10% are men, while the prevalence in men is probably much higher. The problem is that in surgical specialties, we are always thing "1st surgery" while in neuropelveology, the diagnosis is the key for helping the öpatient. If you do the wrong procedure to the wrong nerve and at the wrong location, you will have a nice video for the next congress, but your patient will further suffer. The deal is to hlp the patient 😷

Neuropelveologie is definitively not only surgery, but first the understanding of the conditions and diagnosis

No, we will not make medical diagnosis online, evenmore because clinical examen in necessary as well

@@prmarcpossover I was more into presenting the history of Your patients coming to Your clinic - the step-by-step approach. It would be a perfect guide for other phisicians and patients.

Paralize the nerve is probably to much, but yes, infiltrating the trunk of the nerve could work, if you do it the proper level...and once again, this is the key - the neuropelveological diagnosis 😀

yes, you have wright- if the patint reports on pain in both dermatomes, the lesion/irriattion is probably at the level of the trunk of the nerve

Excellente and very important question. A neurogenic pudendal lesion on one side will not induce any incontinence sofar the contraleteral side is OK. Now I was quite restricting with bilateral BTX infiltration, but I did it in the past without inducing continence. Your question is really good showing that you have already a very good "neuropelveological" knowledge. Congratulation

Dear Kim, I am also very happy about your comment. I hope you carry on with neuropelveology in South Corea ;-)😀

@@prmarcpossover Dear Marc I did not give up, I try find method.

Our pleasure. As very often in medicine, eduction of patient is absolutely mandator for coming forwards 😘

In conditions of the pudendakl nerve, the main question is the exact location of the irritation of the nerve, above vs below the pelvic floor. Th cause is the second diagnosis.

No, diagnosis in neuropelveology is a clinical diagnosis espcially based on patient's history and "neuro-Gyn examination". Imaging permits exclusion of some etiological diagnosis such as schwannoma of a pelvic nerves, a May-Thurner Syndrome....

Independently from the cause, inflammation, endo, injury, pain is an information which always need nerves to be transport to the brain. Even if nerves are not always the cause for the pain, nerves and only nerves bring the "pain information" through the entire body to the brain. With getting this information in your brain, you would not feel pain 😃

Do your legs and arms get paralyzed?

absolutely...alles ist in bewegung, in schwingung...das ist eben das "LEBEN" 😘

No. I’ve has 3 surgeries with 2 different surgeons, different states, they both said the same thing ….they would never dare go near the sciatic nerve. That’s only for neuro surgeons

yes if the SCI is spasptic and AIS B/C😀

Ищите, ищите хирургов в других странах. Это слишком ужасно. Понять боли могут только те, кто болен эндометриозом. ВРАЧИ мрази.

You need a good pain clinic, now! You have to research, not all pain clinics are the same. So make appointments and meet with the Drs, find the one that will listen. It’s worth it!

How are you feeling today?

Hey are u okk now... My self muskan I am 17 years old actually I am also suffering from same condition I can't even get up from my bed it's very painful for me I wanna ask how didi u get relief from this pain

I'm going through this right now!!! I don't know what to do to stop this awful pain. I found a supplement called endolls yesterday that could help, so I placed an order right away, and I'm still waiting for them to ship it. Hopefully it will help!

Have you tried oral contraceptive pills? I also use ice to put pressure on the joint to relieve the pain.

​@@Poonammalvi28oral contraceptive pills have helped me plus using ice

How are you feeling today, how did you resolve the problem?

I’m so sorry. I honestly hope and pray you can find relief. It’s 5:30 am and I haven’t been able to sleep do to pain on my pelvic bones. I’m running out of pain medication and I have my appointment with the pain clinic in ten days from now which is a month nightmare. I have stage 4 endometriosis so severe that my uterus ruptured when I was five months pregnant. My baby was stillborn and I can’t have anymore children, he was my first. I’m still dealing with this and I pray the endometriosis does not invade my nerves.

😔 . I'm praying for all of us to get some relief!

Hi what were your complaints?

I’m curious how the mri showed endo in this location? Everything I’ve heard and read notes that scans such as mri and ultrasound don’t show endometriosis. Which is why you have to do laparoscopic surgery to be diagnosed. I’ve had all these scans and they found nothing so I’m scheduling surgery soon.

@@heatherb9853 I'm glad you have surgery scheduled. This is the first time an MRI has ever shown anything up for me , it is quite rare for endo to be found on scans and usually is only DIE endo that can be seen. I've had 4 surgeries before now and every single MRI scan showed nothing but when I had surgery they found extensive endometriosis each time. Good luck with your surgery I hope it helps you xx

@@vickyhamlin wow that is super crazy! Have the surgeries helped you feel quite a bit better? How is recovery? Thank you for your kind wishes, definitely nervous but hopeful