{"id":12052,"date":"2026-09-22T08:37:45","date_gmt":"2026-09-22T08:37:45","guid":{"rendered":"https:\/\/nygse.com\/?p=12052"},"modified":"2026-09-23T00:01:31","modified_gmt":"2026-09-23T00:01:31","slug":"nerve-sparing-endometriosis-surgery","status":"publish","type":"post","link":"https:\/\/nygse.com\/es\/nerve-sparing-endometriosis-surgery\/","title":{"rendered":"Nerve-Sparing Endometriosis Surgery: Protecting Pelvic Function"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-post\" data-elementor-id=\"12052\" class=\"elementor elementor-12052\" data-elementor-post-type=\"post\">\n\t\t\t\t<div class=\"elementor-element elementor-element-2712a5b3 e-flex e-con-boxed e-con e-parent\" data-id=\"2712a5b3\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-127cbd08 elementor-widget elementor-widget-text-editor\" data-id=\"127cbd08\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>Removing endometriosis is an important goal of surgery. But when <a href=\"https:\/\/nygse.com\/departments\/deep-infiltrating-endometriosis-die\/\">deep endometriosis<\/a> develops close to the nerves that help control the bladder, bowel, and other pelvic functions, surgeons must also consider what lies around the disease.<\/p><p><strong>Nerve-sparing endometriosis surgery<\/strong> is an anatomy-focused surgical approach designed to identify and, when possible, preserve important pelvic nerves while treating endometriosis.<\/p><p>The goal is not simply to remove disease. It is to <a href=\"https:\/\/nygse.com\/treatments\/\">treat endometriosis<\/a> while protecting normal pelvic function whenever safely possible.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-fce18f2 elementor-widget elementor-widget-image\" data-id=\"fce18f2\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img fetchpriority=\"high\" decoding=\"async\" width=\"940\" height=\"627\" src=\"https:\/\/nygse.com\/wp-content\/uploads\/2026\/09\/pelvic-nerves-endometriosis-surgery-1024x683.jpg\" class=\"attachment-large size-large wp-image-12061\" alt=\"Medical illustration showing the hypogastric nerves, pelvic splanchnic nerves, and inferior hypogastric plexus in the female pelvis.\" srcset=\"https:\/\/nygse.com\/wp-content\/uploads\/2026\/09\/pelvic-nerves-endometriosis-surgery-1024x683.jpg 1024w, https:\/\/nygse.com\/wp-content\/uploads\/2026\/09\/pelvic-nerves-endometriosis-surgery-300x200.jpg 300w, https:\/\/nygse.com\/wp-content\/uploads\/2026\/09\/pelvic-nerves-endometriosis-surgery-768x512.jpg 768w, https:\/\/nygse.com\/wp-content\/uploads\/2026\/09\/pelvic-nerves-endometriosis-surgery-18x12.jpg 18w, https:\/\/nygse.com\/wp-content\/uploads\/2026\/09\/pelvic-nerves-endometriosis-surgery-480x320.jpg 480w, https:\/\/nygse.com\/wp-content\/uploads\/2026\/09\/pelvic-nerves-endometriosis-surgery.jpg 1536w\" sizes=\"(max-width: 940px) 100vw, 940px\" title=\"Pelvic Nerves and the Inferior Hypogastric Plexus\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element-custom_font_size elementor-element elementor-element-00b5f7f elementor-widget elementor-widget-text-editor\" data-id=\"00b5f7f\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p style=\"text-align: center;\">Medical Illustration: The hypogastric nerves, pelvic splanchnic nerves, and inferior hypogastric plexus are important pelvic nerves that help control the bladder, bowel, and reproductive organs.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-34c5c0a elementor-widget elementor-widget-heading\" data-id=\"34c5c0a\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Why Do Pelvic Nerves Matter During Endometriosis Surgery?<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-f01c378 elementor-widget elementor-widget-text-editor\" data-id=\"f01c378\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>Deep endometriosis can involve areas of the pelvis close to the autonomic nerves.<\/p><p>These nerves help regulate functions that normally happen without conscious control, including aspects of bladder emptying and bowel function. Important structures include the hypogastric nerves, pelvic splanchnic nerves, and inferior hypogastric plexus. <a href=\"#references\"><sup>[3]<\/sup><\/a><\/p><p>When endometriosis or surrounding fibrosis develops near these structures, surgical dissection may become more complex.<\/p><p>This makes a detailed understanding of pelvic neuroanatomy particularly important during surgery for deep endometriosis.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-0950e61 elementor-widget elementor-widget-heading\" data-id=\"0950e61\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Key Pelvic Nerves in Endometriosis Surgery<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-7145404 elementor-widget elementor-widget-text-editor\" data-id=\"7145404\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>Several autonomic nerve structures are particularly important during surgery for deep endometriosis. These include the <strong>hypogastric nerves, pelvic splanchnic nerves, and inferior hypogastric plexus. <\/strong><a href=\"#references\"><sup>[3]<\/sup><\/a><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-bbaa34a elementor-widget elementor-widget-heading\" data-id=\"bbaa34a\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">Hypogastric Nerves<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-bc0352a elementor-widget elementor-widget-text-editor\" data-id=\"bc0352a\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>Paired sympathetic nerves that descend from the superior hypogastric plexus into the pelvis, passing behind and to either side of the rectum to join the inferior hypogastric plexus.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-a4b2507 elementor-widget elementor-widget-heading\" data-id=\"a4b2507\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">Pelvic Splanchnic Nerves<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-77d796b elementor-widget elementor-widget-text-editor\" data-id=\"77d796b\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>Parasympathetic nerves arising from S2\u2013S4 sacral spinal nerves that enter the pelvis from the posterolateral pelvic wall and travel toward the inferior hypogastric plexus.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-6563f19 elementor-widget elementor-widget-heading\" data-id=\"6563f19\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">Inferior Hypogastric Plexus<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-a1e605f elementor-widget elementor-widget-text-editor\" data-id=\"a1e605f\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>A paired network of autonomic nerves located on each side of the rectum and lower reproductive tract.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-b94c45e elementor-widget elementor-widget-heading\" data-id=\"b94c45e\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">What Is Nerve-Sparing Endometriosis Surgery?<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-eff36f4 elementor-widget elementor-widget-text-editor\" data-id=\"eff36f4\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>Nerve-sparing surgery does not mean leaving endometriosis untreated simply because it is near a nerve.<\/p><p>Instead, the surgeon identifies relevant nerve pathways and carefully separates disease from surrounding anatomy when this can be accomplished safely.<\/p><p>Improved laparoscopic visualization and a better understanding of pelvic neuroanatomy have contributed to techniques that allow surgeons to recognize and preserve these structures during complex pelvic surgery. <a href=\"#references\"><sup>[3]<\/sup><\/a><\/p><p>The exact approach depends on where the endometriosis is located, how deeply it infiltrates surrounding tissues, and which organs or structures are involved.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-524637e elementor-widget elementor-widget-heading\" data-id=\"524637e\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Can Endometriosis Surgery Affect Bladder or Bowel Function?<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-9c443eb elementor-widget elementor-widget-text-editor\" data-id=\"9c443eb\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>It can.<\/p><p>Surgery for deep endometriosis may involve areas close to nerves supplying the bladder and bowel. Injury to these autonomic nerves can contribute to postoperative problems such as difficulty emptying the bladder. <a href=\"#references\"><sup>[2]<\/sup><\/a><\/p><p>Research comparing nerve-sparing and conventional approaches has suggested that nerve-sparing techniques may reduce certain postoperative urinary complications. A systematic review and meta-analysis, for example, found a lower risk of persistent urinary retention after nerve-sparing surgery, although the available evidence was limited and additional controlled studies were recommended. <a href=\"#references\"><sup>[2]<\/sup><\/a><\/p><p>Another study of surgery for posterior deep infiltrating endometriosis found improved immediate postoperative urinary outcomes with systematic nerve sparing, including a reduced need for self-catheterization. <a href=\"#references\"><sup>[4]<\/sup><\/a><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-84f6377 elementor-widget elementor-widget-heading\" data-id=\"84f6377\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Is Nerve-Sparing Surgery Better for Every Patient?<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-f04fad3 elementor-widget elementor-widget-text-editor\" data-id=\"f04fad3\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>Not necessarily.<\/p><p>Endometriosis surgery must be individualized. Disease location and extent can vary considerably from one patient to another, and preservation of a nerve may not always be technically possible or appropriate.<\/p><p>Importantly, the European Society of Human Reproduction and Embryology (ESHRE) does not currently recommend one particular surgical technique for treating pain associated with deep endometriosis because studies differ substantially in their patient populations, surgical approaches, and techniques. <a href=\"#references\"><sup>[1]<\/sup><\/a><\/p><p>ESHRE does recommend that patients with deep endometriosis be referred to a center with appropriate expertise and that patients considering surgery be informed about potential risks, benefits, and long-term effects on quality of life. <a href=\"#references\"><sup>[1]<\/sup><\/a><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-d37e14e elementor-widget elementor-widget-heading\" data-id=\"d37e14e\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Treating Endometriosis While Preserving Pelvic Function<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-83b0878 elementor-widget elementor-widget-text-editor\" data-id=\"83b0878\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>Endometriosis surgery is about more than removing visible disease. In complex cases, surgeons must also consider how endometriosis relates to surrounding structures, particularly the bowel, bladder, ureters, blood vessels, and pelvic nerves.<\/p><p>A careful surgical approach considers both <strong>treatment of the disease and preservation of normal function whenever possible.<\/strong><\/p><p>At <strong>New York Gynecology Surgery &amp; Endometriosis (NYGSE)<\/strong>, Dr. Pankaj Singhal and Dr. Elizabeth McLean evaluate each patient individually, considering symptoms, disease location, pelvic anatomy, and treatment goals when planning endometriosis surgery.<\/p><p>If you have deep endometriosis or are considering surgery, an evaluation with an <a href=\"https:\/\/nygse.com\/meet-the-team\/\"><strong>NYGSE endometriosis specialist<\/strong><\/a> can help determine an appropriate approach for your individual case.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<section class=\"elementor-section elementor-inner-section elementor-element elementor-element-7f40a6e9 elementor-section-content-middle elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"7f40a6e9\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-no\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-33 elementor-inner-column elementor-element elementor-element-5e5bb8ff\" data-id=\"5e5bb8ff\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"gt3-core-button--alignment_block elementor-element elementor-element-1bfba326 elementor-widget elementor-widget-gt3-core-button\" data-id=\"1bfba326\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"gt3-core-button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t<div class=\"gt3_module_button_elementor size_custom 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elementor-element-custom_color elementor-element elementor-element-2190b5aa elementor-widget elementor-widget-text-editor\" data-id=\"2190b5aa\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>CALL FOR AN APPOINTMENT<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element-custom_font_size elementor-element-custom_line_height elementor-element-custom_font_weight elementor-element elementor-element-1f906024 elementor-widget elementor-widget-text-editor\" data-id=\"1f906024\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p><span style=\"color: #31609f;\"><a href=\"tel:631-533-9733\" style=\"color: #31609f;\">+631 533 9733<\/a><\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t<div class=\"elementor-element elementor-element-13c248e e-flex e-con-boxed e-con e-parent\" data-id=\"13c248e\" data-element_type=\"container\" data-e-type=\"container\" id=\"references\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-3820ae43 elementor-widget elementor-widget-heading\" data-id=\"3820ae43\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h5 class=\"elementor-heading-title elementor-size-default\">References<\/h5>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element-custom_font_size elementor-element elementor-element-4bfed5d8 elementor-widget elementor-widget-text-editor\" data-id=\"4bfed5d8\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<ol><li>Becker, C. M., Bokor, A., Heikinheimo, O., Horne, A., Jansen, F., Kiesel, L., King, K., Kvaskoff, M., Nap, A., Petersen, K., Saridogan, E., Tomassetti, C., van Hanegem, N., Vulliemoz, N., &amp; Vermeulen, N. (2022). ESHRE guideline: Endometriosis. <em>Human Reproduction Open, 2022<\/em>(2), hoac009. <a href=\"https:\/\/doi.org\/10.1093\/hropen\/hoac009\" target=\"_blank\" rel=\"noopener noreferrer nofollow\">https:\/\/doi.org\/10.1093\/hropen\/hoac009<\/a><\/li><\/ol><p>2. de Resende J\u00fanior, J. A. D., Cavalini, L. T., Crispi, C. P., &amp; Fonseca, M. F. (2017). Risk of urinary retention after nerve-sparing surgery for deep infiltrating endometriosis: A systematic review and meta-analysis. <em>Neurourology and Urodynamics, 36<\/em>(1), 57\u201361. <a href=\"https:\/\/doi.org\/10.1002\/nau.22915\" target=\"_blank\" rel=\"noopener noreferrer nofollow\">https:\/\/doi.org\/10.1002\/nau.22915<\/a><\/p><p>3. Ribeiro-Julio, G. S., Pereira, J. A., Ribeiro, E., Gallo, C. M., &amp; Favorito, L. A. (2023). Anatomy of the lower hypogastric plexus applied to endometriosis: A narrative review. <em>International Brazilian Journal of Urology, 49<\/em>(3), 299\u2013306. <a href=\"https:\/\/doi.org\/10.1590\/S1677-5538.IBJU.2022.9980\" target=\"_blank\" rel=\"noopener noreferrer nofollow\">https:\/\/doi.org\/10.1590\/S1677-5538.IBJU.2022.9980<\/a><\/p><p>4. Soares, M., Mimouni, M., Oppenheimer, A., Nyangoh Timoh, K., du Cheyron, J., &amp; Fauconnier, A. (2021). Systematic nerve sparing during surgery for deep-infiltrating posterior endometriosis improves immediate postoperative urinary outcomes. <em>Journal of Minimally Invasive Gynecology, 28<\/em>(6), 1194\u20131202. <a href=\"https:\/\/doi.org\/10.1016\/j.jmig.2020.10.016\" target=\"_blank\" rel=\"noopener noreferrer nofollow\">https:\/\/doi.org\/10.1016\/j.jmig.2020.10.016<\/a><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Nerve-sparing endometriosis surgery focuses on treating disease while identifying and preserving important pelvic nerves when 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