At EndoGlobal, we use specialized medical strategies to care for women with deep infiltrating endometriosis (DIE). This care includes neuropelveology, a discipline that integrates neuroscience with pelvic surgery to address complex neuropathic pain caused by endometriosis that invades the pelvic nerves.
Nerve Involvement and Chronic Pelvic Pain
Deep endometriosis can affect major nerve structures such as the superior hypogastric plexus, the sciatic nerve and the sacral nerves. The result can be chronic pain that often does not respond to conventional painkillers or hormonal therapies.
Diagnosis with Neuroanatomical Mapping
We use high-resolution pelvic MRI with neuroanatomical mapping to help detect nerve infiltration. Combined with a specialized clinical evaluation, this imaging helps our team plan surgery with the aim of reducing the risk of neurological complications.
In this video, Dr. Ana Sierra explains how the pain history and the physical exam point to the nerves that Endomapping should check.
Laparoscopic Surgery with Nerve Preservation
Procedures are performed with laparoscopic techniques and intraoperative nerve mapping, which uses electrical stimulation to identify and protect essential nerve branches. This technique aims to:
- Remove endometriosis lesions precisely.
- Preserve motor and sensory nerve function.
- Reduce the risk of persistent pelvic pain after surgery.
Multidisciplinary Care for Neuropathic Pain
Treating nerve-related endometriosis pain goes beyond surgery. Our multidisciplinary team combines:
- 1Pharmacological therapies, including tricyclic antidepressants, anticonvulsants such as gabapentin and pregabalin, and advanced analgesics.
- 2Neuromodulation techniques, such as sacral nerve stimulation or spinal cord stimulation, for patients with treatment-resistant chronic pain.
This comprehensive approach aims to improve pain control and support long-term recovery, and it can help lower the risk of relapse.
