LAUSR

Study Objective This video demonstrates a targeted nervous system evaluation in the setting of a uterine and ovarian conserving surgery Design N/A Setting A single surgical center within a large integrated healthcare system. Patients or Participants The patient is a 49-year-old perimenopausal woman with dysmenorrhea and a left ovarian cyst who presented for evaluation of new onset left hip and leg pain. The left ovarian cyst was first noted 4 years ago and the patient declined surgery at that time, instead opting for surveillance with repeat imaging which now demonstrated an interval increase in the cyst size. The patient had an extensive evaluation for her leg pain including MRI and nerve conduction studies which were all unremarkable. The patient declined medical management or definitive surgical treatment of the suspected endometriosis. She opted for a diagnostic laparoscopy and left ovarian cystectomy. Interventions The patient underwent an uncomplicated diagnostic laparoscopy and left ovarian cystectomy. Given the characteristics of her symptoms, care was taken intra-operatively to examine specific nerves within the lumbosacral plexus. Measurements and Main Results No overt pathology was noted along the sacral, genitofemoral, or obturator nerves. Conclusion In summary, this video demonstrates steps for performing a targeted evaluation of the pelvic nervous system based on patient's symptoms.