Pelvic denervation procedures for dysmenorrhea

Christina M. Ramirez, Christina Ramirez, Ramirez C, Donnellan N, Nicole Donnellan
Current opinion in obstetrics & gynecology · 2017 · vol. 29(4) , pp. 225–230 · doi:10.1097/gco.0000000000000379 · PMID:28683027 · W2732572569
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⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-06-08 ⓘ

This review details surgical pelvic denervation techniques and their efficacy for dysmenorrhea, highlighting presacral neurectomy as a preferred procedure for midline pain, especially with endometriosis.

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Abstract

PURPOSE OF REVIEW: Chronic pelvic pain and dysmenorrhea are common conditions affecting reproductive-age women. Surgical pelvic denervation procedures may be a treatment option for women with midline dysmenorrhea, in which medical management is declined by the patient, ineffective at managing symptoms, or medically contraindicated. This review describes the surgical techniques and complications associated with pelvic denervation procedures as well as the current evidence for these procedures in women with primary dysmenorrhea and dysmenorrhea secondary to endometriosis. RECENT FINDINGS: Presacral neurectomy is the preferred pelvic denervation procedure in patients with primary dysmenorrhea and midline chronic pelvic pain associated with endometriosis. In patients with endometriosis presacral neurectomy is a useful adjunct to excision or ablation of all endometrial lesions to improve postoperative pain relief. There is no additional patient benefit of performing combined presacral neurectomy and uterine nerve ablation procedures. SUMMARY: Pelvic denervation procedures can be performed safely and quickly with a low risk of complication if the surgeon is knowledgeable and skilled in operating in the presacral space. Patients should be adequately counseled on expected success rates and potential complications associated with pelvic denervation procedures.

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Condition tags

dysmenorrheaendometriosischronic_pelvic_pain

MeSH descriptors

Denervation Dysmenorrhea Endometriosis Pelvis Chronic Pain Dysmenorrhea Dysmenorrhea Endometriosis Endometriosis Female Humans Laparoscopy Pelvic Pain Pelvic Pain Pelvis Robotic Surgical Procedures Surgeons Uterine Diseases Uterine Diseases Uterus

Citation neighborhood (2-hop)

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. Outer rings show 2-hop neighbours — papers reached through the immediate citers/citees. [ collapse to 1-hop ]

References (31)

Cited by (6)

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License: CC0 · commercial use OK