Prof. Prof. DK Prof. Dr. med. Marc Possover, MD, PhD

Understanding the Link Between Autoimmune Disease and Pelvic Neuropathic Pain

If you are a woman suffering from chronic pelvic, lower back, or sciatic pain - especially if doctors have told you it’s “unexplained” or “psychosomatic” - this article is for you.

At the Possover International Medical Center in Zurich, we’ve uncovered an often-overlooked but treatable cause of pelvic pain: vascular entrapment of pelvic nerves, particularly in women with autoimmune and connective tissue disorders like Ehlers-Danlos Syndrome (EDS), or blodd diseases with increased risk from thrombosis like May-Thurner Syndrome, Nutcracker syndrome, Thalassemia or Factor V leiden mutation.

WHAT IS VASCULAR ENTRAPMENT?

In many women, especially those with autoimmune conditions, abnormally placed or enlarged blood vessels can compress pelvic nerves. This is known as vascular entrapment, and it may affect:

• The sciatic nerve (causing pain down the leg or in the buttock),
• The pudendal nerve (causing burning, stabbing, or pressure in the vulva, perineum, or rectal area),
• The sacral nerves (causing bladder or bowel dysfunction, genital numbness or hypersensitivity, or deep pelvic pain).

This condition is not visible on standard MRI scans, and is often misdiagnosed as endometriosis, interstitial cystitis, irritable bowel syndrome - or simply “chronic pelvic pain syndrome of unknown origin.”

COULD THIS BE YOU?

Ask yourself:

• Does your pain worsen when sitting, during your period, or after intercourse?
• Does it improve or disappear at night when you lie down?
• Have you been diagnosed with Joint Hypermobility Syndrome, Ehlers-Danlos-Syndrome (EDS), Hashimoto’s thyroiditis, Lupus, or another autoimmune condition?
• Do you suffer from sciatic pain, vulvodynia, or unexplained bladder issues (Interstitiel Cystitis, chronic UI)?

If so, your pain may be caused by vascular entrapment - and it’s treatable.

WHY AUTOIMMUNE DISEASES PLAY A ROLE?

In a study of 128 women with confirmed pelvic nerve compression at the Possover International Medical center (over the last 2 years), 2 in 3 had an autoimmune disease — and nearly 52% had EDS or a similar connective tissue disorder.

These conditions can weaken the blood vessels, make them more prone to enlargement, and trigger inflammation that leads to nerve irritation.

In other words: Your immune system might be contributing to your pain - by affecting your blood vessels and compressing your nerves.

DIAGNOSIS: WHAT WORKS (AND WHAT DOESN'T)

Unfortunately, MRI scans often miss this condition - not because it isn’t real, but because radiologists aren’t trained to look for it.

Instead, we’ve found that vaginal sonography with Doppler - a special ultrasound that shows how blood flows in the pelvic veins - is far more accurate.

Combined with your symptoms and medical history, this allows us to identify the exact nerves involved and the location of the compression.

REAL TREATMENT, REAL RESULTS

With more than 20 years of experience in Neuropelveology, we perform at our center laparoscopic nerve decompression - a minimally invasive surgery to release the affected nerves from the surrounding blood vessels. This procedure doe’snt belong Gynecology, but vascular surgery performed by laparoscopy.

After surgery, over 75% of women report at least a 50% reduction in pain - many after years, even decades, of suffering without a diagnosis.

“I thought I was going crazy. I had seen over 10 doctors. When Professor Possover finally explained what was going on and treated it, it changed my life.”
- A former patient

WHY EXPERTISE MATTERS IN VASCULAR ENTRAPMENT SURGERY?

Surgical treatment for vascular entrapment of pelvic nerves is a highly delicate and specialized procedure — it is not gynecologic surgery, even if it uses laparoscopic access. It is, in fact, a vascular procedure requiring deep knowledge of neuroanatomy and vascular anatomy.

To safely and effectively perform this surgery, the surgeon must have an exact understanding of where pelvic nerves run, how they can be compressed, and how to identify the problem without performing unnecessary or dangerous dissections. Equally important is a thorough knowledge of the pelvic blood vessels to avoid complications such as intraoperative hemorrhage, which can potentially be life-threatening.

Furthermore, to prevent persistent pain after surgery and avoid the need for a second operation, metal clips should never be used. Although clips are commonly used in gynecologic or general laparoscopic surgery for closing blood vessels, in the context of pelvic nerves, they can irritate or even damage the nerves after surgery. During decompression surgery for vascular entrapment, the compressing veins must not only be closed but fully resected - simply clipping them is not enough.

Importantly, this procedure has no negative impact on fertility or other pelvic organs. Only the veins compressing the nerves are treated - not the entire pelvic vessels network, which remains richly supplied. This is why a precise preoperative neuropelveological diagnosis is essential: to identify the exact nerves involved, their location, and the specific vessels causing compression.

When done correctly, this surgery offers significant pain relief and can be life-changing for women suffering from chronic pelvic nerve pain. But it must be performed by a surgeon who is trained in neuropelveology, understands vascular and nerve anatomy, and is experienced in laparoscopic nerve decompression.

FINAL THOUGHTS

If you're struggling with unexplained pelvic pain, don’t give up.

What you’re feeling is real, and there may be a very real, very treatable cause behind it.

✅ Trust your body.
✅ Ask the right questions.
✅ Seek specialists who understand pelvic nerves and vascular conditions, a Neuropelveologist - not just gynecology or urology.

We’re Here to Help

Possover International Medical Center – Zurich
☎️ +41 44 520 3600
📍 Klausstrasse 4, CH-8002 Zürich
🌐 www.possover.com
📧 mail@possover.com

Let us help you find the cause of your pain — and finally start your journey toward healing.

If you or someone you know is struggling with chronic pelvic pain, pelvic nerve disorders, endometriosis, or consequences of pelvic surgery, please contact us via email at international@possover.com to begin the process. Because we want to avoid the scenario where a patient travels to Zurich, only to discover that we may not be able to offer help for their specific situation, we have Pre-Consultation Zoom process. How does it work?

1. Patients will first receive a Pre-Consultation Form.
2. Based on the information provided, we will assess whether a Zoom consultation is necessary.
3. If indicated, we will schedule a Pre-Consultation Zoom Call to help determine if a full evaluation at our center makes sense for your case.