title: Risks, symptoms, and management of pelvic nerve damage secondary to surgery for pelvic organ prolapse: a report of 95 cases.
abstract: OBJECTIVE
  This study aims to report pelvic nerve damage secondary to surgical treatment of pelvic organ prolapse and the role of laparoscopy in the diagnosis and treatment of such nerve damage.
  
  
  METHODS
  Ninety-five consecutive patients complaining of pain and/or bladder or bowel dysfunction following surgery for pelvic prolapse underwent laparoscopic exploration for pelvic neuropathy.
  
  
  RESULTS
  A mean reduction in visual analog score (VAS) from 8.9 (± 0.96; 6-10) preoperatively to 2.9 (± 2.77; 0-6) at 1-year follow-up was obtained in patients after laparoscopic nerve decompression (n = 90; p < 0.001). Success, defined as a reduction in VAS score of greater than 50%, was obtained in 84% of patients. Sixty-five patients (68%) discontinued the regular use of analgesics.
  
  
  CONCLUSIONS
  Because secondary nerve damage can appear months or years after the primary procedure, long-term follow-up is mandatory and should focus on nerve damage as well as anatomical and functional outcomes. Laparoscopy is a unique method for etiologic diagnosis and neurosurgical treatment of such nerve lesions through decompression or implantation of an electrode for neuromodulation.
authors: Department of Surgical Gynecology & Neuropelveology, Hirslanden Clinic, Witellikerstrasse 40, 8032 Zürich, Switzerland. marc.possover@hirslanden.ch
authors: Marc
authors: M
authors: Possover
authors: Nucelio
authors: N
authors: Lemos
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019299:Decompression, Surgical; D019468:Disease Management; D004599:Electric Stimulation Therapy; D005260:Female; D005500:Follow-Up Studies; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects*; D006801:Humans; D008875:Middle Aged; D010147:Pain Measurement; D056887:Pelvic Organ Prolapse / Q000601:surgery*; D017699:Pelvic Pain / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D010388:Pelvis / Q000294:innervation*; D012189:Retrospective Studies; D012307:Risk Factors; D020196:Trauma, Nervous System / Q000453:epidemiology* / Q000209:etiology* / Q000628:therapy; D016896:Treatment Outcome; D001750:Urinary Bladder, Neurogenic / Q000453:epidemiology / Q000209:etiology / Q000628:therapy