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Sensory nerve injury after uterosacral ligament suspension.

Publication ,  Journal Article
Flynn, MK; Weidner, AC; Amundsen, CL
Published in: Am J Obstet Gynecol
December 2006

OBJECTIVE: Uterosacral ligament suspension is a technique that is performed commonly to suspend the prolapsed vaginal apex. This case series describes our experience with the clinical evaluation and management of lower extremity sensory nerve symptoms after uterosacral ligament suspension. STUDY DESIGN: Hospital and office medical records from our 2 institutions were reviewed from January 2002 to August 2005, and all women who underwent uterosacral ligament suspension through a vaginal approach were identified. Women with symptoms of buttock and posterior thigh pain during the 6-week postoperative period were identified, and detailed clinical information was abstracted from the charts. RESULTS: From 182 uterosacral ligament suspension procedures, 7 women were identified. The age range was 42 to 70 years. Concurrent procedures included 6 vaginal hysterectomies, 5 anterior repairs, 4 posterior repairs, 2 slings, and 1 bilateral salpingo-oophorectomy. Within 24 hours of the surgical procedure, all the women experienced similar, substantial sharp buttock pain and numbness that radiated down the center of the posterior thigh to the popliteal fossa in 1 or both lower extremities. The ipsilateral uterosacral ligament suture was removed within 2 days of the procedure in 3 women who had immediate subjective reduction in their pain and complete resolution of pain by 6 weeks. The remaining 4 women were treated with gabapentin and narcotics. Three women had resolution of the pain by 12 to 14 weeks after the operation, and the last woman's pain resolved gradually by 6 months. CONCLUSION: Women who undergo uterosacral ligament suspension are at risk of postoperative pain and numbness in a S2-4 distribution. These symptoms appear to be related to the placement of uterosacral ligament sutures and may be relieved either by prompt removal of the ipsilateral uterosacral ligament suture or with prolonged medical therapy.

Duke Scholars

Published In

Am J Obstet Gynecol

DOI

EISSN

1097-6868

Publication Date

December 2006

Volume

195

Issue

6

Start / End Page

1869 / 1872

Location

United States

Related Subject Headings

  • Wounds and Injuries
  • Uterine Prolapse
  • Treatment Outcome
  • Pregnancy
  • Peripheral Nerve Injuries
  • Pain, Postoperative
  • Obstetrics & Reproductive Medicine
  • Middle Aged
  • Leg
  • Hypesthesia
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Flynn, M. K., Weidner, A. C., & Amundsen, C. L. (2006). Sensory nerve injury after uterosacral ligament suspension. Am J Obstet Gynecol, 195(6), 1869–1872. https://doi.org/10.1016/j.ajog.2006.06.059
Flynn, Michael K., Alison C. Weidner, and Cindy L. Amundsen. “Sensory nerve injury after uterosacral ligament suspension.Am J Obstet Gynecol 195, no. 6 (December 2006): 1869–72. https://doi.org/10.1016/j.ajog.2006.06.059.
Flynn MK, Weidner AC, Amundsen CL. Sensory nerve injury after uterosacral ligament suspension. Am J Obstet Gynecol. 2006 Dec;195(6):1869–72.
Flynn, Michael K., et al. “Sensory nerve injury after uterosacral ligament suspension.Am J Obstet Gynecol, vol. 195, no. 6, Dec. 2006, pp. 1869–72. Pubmed, doi:10.1016/j.ajog.2006.06.059.
Flynn MK, Weidner AC, Amundsen CL. Sensory nerve injury after uterosacral ligament suspension. Am J Obstet Gynecol. 2006 Dec;195(6):1869–1872.
Journal cover image

Published In

Am J Obstet Gynecol

DOI

EISSN

1097-6868

Publication Date

December 2006

Volume

195

Issue

6

Start / End Page

1869 / 1872

Location

United States

Related Subject Headings

  • Wounds and Injuries
  • Uterine Prolapse
  • Treatment Outcome
  • Pregnancy
  • Peripheral Nerve Injuries
  • Pain, Postoperative
  • Obstetrics & Reproductive Medicine
  • Middle Aged
  • Leg
  • Hypesthesia