Abstract
Background: Many women suffer from undiagnosed pelvic pain,
potentially due to pelvic neuropathies, but are often treated
symptomatically without addressing underlying causes. Pelvic
neuropathies can cause severe symptoms, affecting quality of life and
psychological well-being. Objectives: To provide an overview of
all known aetiologies of pelvic neuropathies. Search Strategy:
Database searches of PubMed, Embase.com, and Web of Science (Core
Collection), as well as citations and reference lists published up to
November 13, 2023. Selection criteria: For inclusion, the study
needed to describe an aetiology of a located pelvic neuropathy that can
occur in women. Excluded studies were those describing idiopathic
neuropathy, reviews, and opinion articles. Main results: In
total, 306 studies were included (268 case reports and series, 38 cohort
studies), describing 2413 patients. Aetiologies of the included studies
were divided into five categories and their subcategories, namely:
iatrogenic (n=1094 patients, 45%), nerve invasion - mainly
endometriosis (n=614 patients, 25%), pregnancy and birth (n=93
patients, 4%), trauma (n=202 patients, 8%), and compression (n=409
patients, 17%). Pelvic neuropathies were mainly described in the
sciatic, femoral, obturator, lumbosacral roots, pudendal, lateral
femoral cutaneous, and Ilioinguinal nerve. Conclusions: The
vast majority of all described pelvic neuropathies were seen after
surgery in the lower abdomen or pelvis. The second largest group of
patients exhibited neuropathy caused by deep endometriosis of the sacral
plexus and/or sciatic nerve. The five categories from this paper can
assist clinicians in diagnosing and treating neuropathic pelvic pain.
Funding: This study was not funded.