Temporary Obturator Neuropathy Suspected as a Result of Obturator Fossa Edema After Debulking Surgery
2005
Summary Objective Obturator nerve injury is a rare complication of obstetric or gynecologic surgery. We present a rare case of obturator nerve injury due to edematous compression of the obturator fossa during the debulking operation. Case Report A 49-year-old, gravida 2, para 2, woman complained of left thigh weakness after a debulking operation for left-side ovarian cancer. The left thigh weakness was noted on the first postoperative day due to loss of thigh adductor control. Left obturator nerve injury was, therefore, suspected after consultation with a neurologist. On the third postoperative day, electromyography was arranged, which revealed a lesion on the left obturator nerve at the pelvis. The procedures employed in the operation were reviewed: neither obturator lymph node dissection nor incision of the obturator sheath had been performed. Obturator fossa edema leading to left obturator nerve compression was suspected. The patient received bedside exercise after hospitalization and regular home exercise after discharge. Six weeks after the operation, the left thigh weakness had improved and the patient could walk freely without any assisting devices. Conclusions Although obturator nerve injury is a rare complication of gynecologic surgery, one should always be alert to the risk of nerve injury if a patient complains of muscle weakness in the thigh. If the diagnosis is confirmed, conservative physiotherapy and rehabilitation can contribute to satisfactory results.
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