{
  "abstract": "Endometriosis is a systemic, estrogen dependent neuroinflammatory-mediated disease affecting approximately 10–15% of women of reproductive age. Clinical manifestations include chronic pelvic pain (CPP), dysmenorrhea, dyspareunia, dyschezia, dysuria, and infertility. Endometriosis-associated pain is multifactorial and comprises overlapping nociceptive, neuropathic, and nociplastic pain phenotypes driven by persistent inflammation, neuroangiogenesis, peripheral nerve involvement, and central sensitization (CS). These mechanisms may sustain pain beyond lesion excision, highlighting the importance of pelvic nervous system (PNS) involvement. This narrative review examines the role of neuropelveology (NP) in endometriosis, focusing on pain mechanisms, diagnostic implications, and surgical decision making. NP integrates pelvic neuroanatomy and neurophysiology into structured neurological assessment, pain mapping, symptom localization, and nerve sparing surgery. Current evidence suggests that NP may complement conventional evaluation in selected patients with refractory pain, neuropathic symptoms, discordance between symptom severity and imaging findings, or suspected involvement of the sacral plexus or sciatic nerve. Recognizing distinct pain phenotypes may support individualized treatment planning by balancing lesion excision with neural preservation and identifying patients who may benefit from multidisciplinary pain management, rehabilitation, neurolysis, or neuromodulation. Although current evidence remains limited, NP should be considered a complementary framework rather than a replacement for established endometriosis management. Prospective multicenter studies using standardized diagnostic criteria and long-term functional outcomes are needed to define its clinical utility.",
  "abstract_shown": true,
  "affiliations": [
    "Escuela de Ciencias de la Salud, Universidad Anáhuac Puebla, Puebla 72810, Mexico",
    "Centro de Investigación en Ciencias de la Salud (CICSA), Facultad de Ciencias de la Salud Universidad Anáhuac México Norte, Huixquilucan 52786, Mexico",
    "Department of Neurosurgery and Brain Repair, Center of Excellence for Aging and Brain Repair, Morsani College of Medicine, University of South Florida, Tampa, FL 33612, USA",
    "Centro de Rehabilitación e Inclusión Infantil Teletón Estado de México, Tlalnepantla 54010, Mexico",
    "Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de México 04510, Mexico",
    "Facultad de Ciencias de la Salud, Universidad Panamericana, Ciudad de México 03920, Mexico",
    "Female Pelvic Surgery Department, Doyenne High Quality and Multidisciplinary Treatment Center for Endometriosis, Ciudad de México 06700, Mexico"
  ],
  "article_type": "review article",
  "arxiv": null,
  "author_total": 18,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Cano-Herrera Gabriela",
      "orcid": "0009-0006-1334-0399"
    },
    {
      "affs": [
        1
      ],
      "name": "Ericka Cristina Loza López",
      "orcid": "0000-0003-2839-0963"
    },
    {
      "affs": [
        1
      ],
      "name": "Maria Fernanda Bautista Gonzalez"
    },
    {
      "affs": [
        1,
        2
      ],
      "name": "Felipe Esparza Salazar",
      "orcid": "0000-0003-1884-5389"
    },
    {
      "affs": [
        1
      ],
      "name": "Tamara Mena Guerrero",
      "orcid": "0009-0004-1851-6774"
    },
    {
      "affs": [
        1
      ],
      "name": "Diego De León Vela",
      "orcid": "0009-0004-7282-9472"
    },
    {
      "affs": [
        1
      ],
      "name": "Ximena A. van Tienhoven",
      "orcid": "0000-0003-1127-9548"
    },
    {
      "affs": [
        3
      ],
      "name": "Emmanuel Simental Aldaba",
      "orcid": "0000-0001-8504-8457"
    },
    {
      "affs": [
        4
      ],
      "name": "Patricia Carolina Massieu Pérez"
    },
    {
      "affs": [
        5
      ],
      "name": "Layra Mena García",
      "orcid": "0009-0005-3378-4897"
    },
    {
      "affs": [
        6
      ],
      "name": "Eder Gabriel Rivera Rosas",
      "orcid": "0009-0000-9778-6959"
    },
    {
      "affs": [
        6
      ],
      "name": "Dante Carbajal Ocampo"
    },
    {
      "affs": [
        6
      ],
      "name": "Ramiro Cabrera Carranco",
      "orcid": "0000-0003-3823-3283"
    },
    {
      "affs": [
        6
      ],
      "name": "Perla Sofía Vera Hernández",
      "orcid": "0009-0009-9335-7503"
    },
    {
      "affs": [
        6
      ],
      "name": "Axel Ranferi García Gaona",
      "orcid": "0009-0001-0866-4819"
    },
    {
      "affs": [
        6
      ],
      "name": "Jonathan Fidel Cueto Camara"
    },
    {
      "affs": [
        1
      ],
      "name": "Javier Iván Armenta Moreno"
    },
    {
      "affs": [
        6
      ],
      "name": "Ana Gabriela Sierra Brozon",
      "orcid": "0009-0002-1898-9577"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/egmke6v0f15qs.bib",
  "cited_by": 0,
  "doi": "10.3390/jcm15208177",
  "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13705954/?tool=EBI",
  "id": "egmke6v0f15qs",
  "issns": [
    "2077-0383"
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  "landing_url": "https://www.mdpi.com/2077-0383/15/20/8177",
  "language": "eng",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2743|Endometriosis Research and Treatment"
    ]
  ],
  "openalex": "W7204236128",
  "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13705954/pdf/?tool=EBI",
  "pmcid": "PMC13705954",
  "pmid": null,
  "published": "2026-10-01",
  "publisher": "MDPI AG",
  "ris": "https://research.draconitic.com/paper/egmke6v0f15qs.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:01Z",
      "native_id": "10.3390/jcm15208177",
      "source": "crossref",
      "url": "https://www.mdpi.com/2077-0383/15/20/8177"
    },
    {
      "first_seen": "2026-10-30T12:21:25Z",
      "native_id": "PMC:PMC13705954",
      "source": "europepmc",
      "url": "https://europepmc.org/article/PMC/PMC13705954"
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  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2743|Endometriosis Research and Treatment",
      "subfield": "reproductive-child"
    }
  ],
  "title": "Neuropelveology in Endometriosis: Pain Mechanisms, Diagnostic Implications, and Surgical Decision-Making",
  "title_text": "Neuropelveology in Endometriosis: Pain Mechanisms, Diagnostic Implications, and Surgical Decision-Making",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:21:25Z",
  "url": "https://research.draconitic.com/paper/egmke6v0f15qs",
  "venue": "Journal of Clinical Medicine",
  "versions": []
}