Sciatica After Pelvic Mesh Surgery – Was It Misdiagnosed?

A 2007 medical literature review took a look at the relationship between sciatica and the female pelvis. While pelvic mesh surgery was not implicated, pelvic mesh had not been in use very long when the study was conducted and more research is needed. However, surgical mesh bladder slings and posterior repair kits have been implanted, sometimes surgically shredded and later removed since 1998 and should be considered when sciatica follows pelvic or abdominal surgery. This is today’s mesh trouble.

Sciatic nerve pain, or sciatica, is most often due to a bulging or herniated disc in your spine pinching your sciatic nerve but gynecological surgery can also be the culprit. The 2007 study found cases in which the cause was gynecological or obstetrical and trauma due to pelvic surgery was misdiagnosed as disc disease in two cases. Unfortunately, in the 127 cases, it took an average of 3.8 years for the gynecological connection to be discovered (in one case, it took an astounding 15 years). The proper diagnosis was crucial because misdiagnosis sometimes lead to unnecessary, unsuccessful, debilitating and distressful spine surgeries. (Other causes of sciatica include spine trauma, osterarthritis, degenerative disc disease, pregnancy, endometriosis, and spinal tumors.)

"Jack-Knife" position
The sacral plexus, where sciatica originates, is immediately next to the posterior pelvic wall, the internal iliac blood vessels, the ureters, and the sigmoid colon (last loop of colon) and the terminal ilieal coils of the small intestine. When posterior mesh is used, there is greater risk of injury to those structures.

During abdominal surgery, nerve injury is usually related to poor patient positioning, a nerve being cut during the procedure, or excessive pressure on the nerve by the surgeon, particularly when he/she is trying to control bleeding from the hypogastric vessels. The use of the “jack-knife” position for vaginal surgery can cause nerve injury if the body is hyperextended or legs are rotated outward excessively.

Jack-Knife position.

Jack-Knife position.

“Vaginal operations have occasionally been complicated by sciatic neurophathy, possibly because of stretching of the sciatic nerve rather than direct pressure.” Other causes include badly placed intermuscular, or IM, injections (into the sciatic nerve), constriction by scar tissue and damage by the chemicals in the injection.

The sciatic nerve is the longest nerve in your body, branching out from your lower back, moving through both buttocks and down through your legs to your feet and is responsible for the movement and feelings in your legs and feet. If it becomes compressed, injured or inflamed, it can cause intense sciatic nerve pain anywhere along its path. No two cases are alike.

Sciatica due to pelvic issues is often diagnosed. The diagnosis is made by listening to your entire story, and conducting physical and neurological exams of your pelvis, back and legs. Special tests include and electromyogram (EMG) and nerve conduction velocity tests. Xray, CT or specialized MRI’s can identify abnormalities and specialized views of the pelvis are necessary.

MESH IS FOR belly dancing

Symptoms:
•    Unpleasant, painful, sensations from your back all the way down your leg to your foot, on one side or both.
•    Weakness, burning, numbness or tingling of the same area.

Treatment depends on the severity of your problems and any additional complications and includes physical therapy, chiropractic treatment, and exercises. You may also need to take tylenol (acetaminophen) or anti-inflammatory drugs. Some exercises that help include good posture, abdominal crunches, walking and swimming and careful attention to body mechanics while lifting.  Medications used to treat chronic nerve pain may also help.

Sciatica often goes away on its on after a period of rest and limited activities. Most people recover after 6 weeks but, for those who continue to suffer, this mesh trouble changes their life.

4 responses to “Sciatica After Pelvic Mesh Surgery – Was It Misdiagnosed?

  1. For 26 long years have suffered from injury to sciatic/S1 nerve following Obturator Hernia laparotomy. Came out of surgery with foot drop, followed by muscle atrophy, unable to walk for months, and severe pain. Nerve blocks have had no effect, nor have meds. A recent hip/pelvic MRI showed clips blocking the sciatic nerve. Now wondering if the sciatic nerve has been clipped, or if perhaps the mesh has somehow caused the injury. Also have inner thigh, groin and pelvic pain, probably from the obturator nerve. Any comments?

    • Hi Marina, It is hard to read your story and hear how long you’ve suffered. I’m not sure what a Obturator Hernia laparotomy is but I hope you’ll be able to find an expert who can help. If the surgical clip was placed in a major nerve, it may very well cause severe neurological problems like what you describe. Have you had time to look at the page (“Find Your Nerve”) because it seems like you have be having several two or more different nerve problems at the same time.
      If you’d like, feel free to send me an email to discuss this further and see if I can help you find the right specialist who can help you. Daywriter1@gmail.com Peggy

  2. justina echols Sparrow

    I had mesh surgery in July 2016 and immedietly after recovery i told the nurse that my legs were in pain she reassured me that nothing was done to my legs…. severe pain since july saw the surgeon and he wants to go back in and shorten the mesh/sling. Since then I ‘ve seen my primary care which ordered a MRI and my gyno both have said going back in probably won’t fix the problem. Also did PT nothing still pain. My surgery is scheduled for Feb 14th 2017 PLEASE help me as this date is approaching….Don’t know what to do…sick of being in pain MRI results should be back 02/7/2017

    • What kind of sling was it? Do you know? If not, ask the hospital medical records department for your entire operative report and tell them you especially want a copy of the label that was on your device. Tell them it may be on a separate piece of paper, all by itself.
      If you send me an email with your location, I can refer you to a surgeon who will not do what your surgeon is proposing. Tightening or shortening your sling will likely aggravate your nerve injury. MRI is not a reliable indicator of the location of your mesh. Did they order it to try to locate the source of your nerve injury?
      Email: daywriter1@gmail.com

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