title: Sensory neuropathy following suspension of the vaginal apex to the proximal uterosacral ligaments.
abstract: OBJECTIVE
  Reports of sensory neuropathy attributed to uterosacral ligament suspension (USLS) have emerged. The objectives of this study were to assess the rate of sensory neuropathy symptoms following transvaginal USLS at a single institution during a 5-year period and to describe the evaluation, management, and outcomes in these patients.
  
  
  METHODS
  A retrospective review of records identified 278 women who underwent transvaginal USLS during the study period. Inpatient and outpatient records within the first 4 weeks postsurgery were reviewed. Women with new-onset buttock and/or lower-extremity pain, numbness, weakness or a combination of these symptoms were identified. Demographic data, intraoperative data, and management modalities and outcomes were collected.
  
  
  RESULTS
  Nineteen (6.8 %) women met criteria for inclusion. The most common symptom was buttock pain (73.7 % of cases). Pain radiation to the ipsilateral posterior thigh was present in 11 cases (57.9 %). The majority of women (73.7 %) reported pain symptoms on the right side. Conservative treatment modalities were initially implemented in all women. Four women (21 %) underwent suture removal a median of 1.75 months after USLS. Full symptom resolution was reported in 13 (68.4 %) women a median of 6 months after USLS. The remaining women experienced partial symptom resolution with ongoing conservative management.
  
  
  CONCLUSIONS
  Sensory neuropathy is common in women who undergo transvaginal USLS. As quality of life may be significantly affected, any symptoms of buttock or lower-extremity pain in the immediate postoperative period warrant a thorough evaluation and close follow-up, with early suture removal consideration.
authors.affiliation: Division of Female Pelvic Medicine and Reconstructive Surgery, MC 9032, Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA. teodoro.montoya@utsouthwestern.edu
authors.forename: T Ignacio
authors.initials: TI
authors.lastname: Montoya
authors.forename: Hillary I
authors.initials: HI
authors.lastname: Luebbehusen
authors.forename: Joseph I
authors.initials: JI
authors.lastname: Schaffer
authors.forename: Clifford Y
authors.initials: CY
authors.lastname: Wai
authors.forename: David D
authors.initials: DD
authors.lastname: Rahn
authors.forename: Marlene M
authors.initials: MM
authors.lastname: Corton
mesh_terms: D000290:Adnexa Uteri / Q000601:surgery; D000328:Adult; D000368:Aged; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects*; D006801:Humans; D008022:Ligaments / Q000601:surgery*; D008875:Middle Aged; D009437:Neuralgia / Q000209:etiology*; D010292:Paresthesia / Q000209:etiology; D014596:Uterine Prolapse / Q000601:surgery*; D014621:Vagina / Q000601:surgery*