In this episode, Dr. Nicholas Fogelson and Dr. Shanti Mohling dive deep into the complex overlap between endometriosis and nerve-related pelvic pain. They discuss a pivotal paper by Dr. Marc Possover on laparoscopic treatment for endometriosis and vascular entrapment of the sacral plexus — groundbreaking work that opened new paths for addressing sciatica caused by pelvic disease. The conversation explores how nerve irritation and compression can manifest, why menstrual cycle patterns matter, and how careful patient selection guides surgical decisions. If you or someone you know has unexplained sciatic or pelvic pain that worsens cyclically, this episode is essential listening.

For clinical consultations: contact Northwest Endometriosis and Pelvic Surgery in Portland, OR at (503) 715-1377 or email us at [email protected] 

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Highlights:

• Why “sciatica” describes symptoms — not a standalone diagnosis — and how to trace its true source.
• The critical differences between sciatic nerve endometriosis, sacral nerve root involvement, and vascular compression.
• How menstrual cycle timing can provide vital clues to nerve-related pain origins.
• The role of neuropelveology in surgically addressing complex pelvic nerve pain
• What patients can realistically expect from surgery — and why improvement, not perfection, is the goal.

 

Download a transcript of this episode.