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Rare cause of paraparesis: bilateral obturator neuropathy after hysterosalpingectomy
  1. Roberto López-Blanco1,2,
  2. Inmaculada Mejía-Jiménez3,
  3. Carlos Pablo de Fuenmayor-Fernández de la Hoz1,
  4. Juan Ruiz-Morales1
  1. 1Department of Neurology, Hospital Universitario 12 de Octubre, Madrid, Spain
  2. 2Department of Neurology, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, Spain
  3. 3Department of Obstetrics and Gynecology, Hospital Universitario 12 de Octubre, Madrid, Spain
  1. Correspondence to Roberto López-Blanco, robretolb{at}


Bilateral obturator nerve injury during pelvic surgery is an infrequent cause of lower limb paraparesis. We report the case of a 45-year-old woman with a large uterine leiomyoma who underwent simple total hysterectomy and bilateral salpingectomy. At 24 h after the surgery, the patient noticed loss of muscle strength when adducting both legs. She had no problem with other movements and no sensory or sphincter abnormalities. Neurological examination confirmed that there was loss of strength only in the adductor muscles, with preserved sensory function and reflexes, suggesting bilateral obturator nerve involvement. Pelvic MRI showed a small postsurgical haematoma in the Douglas recess, but far from the obturator nerves. 2 weeks later, electromyography showed positive sharp waves and low motor unit recruitment in the adductor magnus muscles, confirming acute, bilateral obturator nerve neuropathy. The few cases of bilateral obturator neuropathy that have been reported were mostly related to abdominopelvic interventions.

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