Laparoscopic presacral neurectomy. Results of the first 25 cases.
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Laparoscopic presacral neurectomy was developed as an outpatient surgical option for patients with chronic pelvic pain and dysmenorrhea who did not respond to medical management.
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Abstract
Since the 1960s, medical therapy utilizing nonsteroidal antiinflammatory drugs and oral contraceptives with the addition of danazol and gonadotropin releasing hormone have become the treatment of choice for chronic pelvic pain and dysmenorrhea. The surgical approach to this problem, incorporating interruption of the superior hypogastric nerve plexus (presacral neurectomy), therefore, has become less popular. Investigations, however, have demonstrated that 20-25% of patients treated medically for this problem fail to show an improvement. As a result, attention has turned once again toward surgical treatment for those who have failed to respond to medical management. Laparoscopic uterosacral nerve ablation, or laparoscopic uterine nerve ablation, appears to offer hope in this regard and represents a return to a surgical approach for conservative management of severe, disabling dysmenorrhea and pelvic pain in women who have failed medical treatment. Since there has been such an emphasis on outpatient treatment and surgery, a laparoscopic approach to the classic presacral neurectomy was devised and implemented.
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- Management of chronic pelvic pain: evidence from randomised controlled trials 2006
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- Long-term Effectiveness of Presacral Neurectomy for the Treatment of Severe Dysmenorrhea Due to Endometriosis 2004
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- Laparoscopic presacral neurolysis for endometriosis-related pelvic pain 2003
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- Addition of Laparoscopic Uterine Nerve Ablation to Laparoscopic Bipolar Coagulation of Uterine Vessels for Women with Uterine Myomas and Dysmenorrhea 2001
- Medical and Surgical Therapies for Pain Associated with Endometriosis 2001
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- Surgical pelvic neuroablation for chronic pelvic pain: a systematic review 2000
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- Surgical interruption of pelvic nerve pathways for primary and secondary dysmenorrhoea 1999
- The role of laparoscopy in the management of pelvic pain in women of reproductive age 1997
- The Efficacy and Complications of Laparoscopic Presacral Neurectomy in Pelvic Pain 1997
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- Laparoscopic Presacral Neurectomy Utilizing Contact-tip Nd: YAG Laser. 1996
- Endometriosis: An Enigmatic Disease 1996
- The role of laparoscopy in the evaluation of chronic pelvic pain: Pitfalls with a negative laparoscopy 1996
- Efficacy of Laparoscopic Pelvic Denervation in Central-Type Chronic Pelvic Pain: A Multicenter Study 1996
- The History of Surgical Treatment of Endometriosis 1995
- Pain recurrence: A quality of life issue in endometriosis 1995
- 12 Advanced laparoscopic procedures for pelvic pain and dysmenorrhoea 1995
- Techniques for Ablation and Excision of Endometriosis 1995
- Adjunctive Procedures in Treatment of Endometriosis: LUNA, Presacral Neurectomy, and Uterine Suspension 1995
- Laparoscopic treatment of chronic pelvic pain in 100 adult women 1995
- Endoscopic surgery in gynecologic practice 1995
- SURGICAL MANAGEMENT OF CHRONIC PELVIC PAIN 1993
- The role of lasers in the laparoscopic treatment of infertility and endometriosis 1993
- The Role for Laparoscopic Presacral Neurectomy 1993
- Breaking New Ground or Just Digging a Hole? An Evaluation of Gynecologic Operative Laparoscopy 1992
- Laparoscopic Uterine Nerve Ablation, Presacral Neurectomy, and Appendectomy 1992
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