Adjunctive Procedures in Treatment of Endometriosis: LUNA, Presacral Neurectomy, and Uterine Suspension

Sanford M. Markham, John A. Rock
In: Endometriosis · 1995 · pp. 117–126 · doi:10.1007/978-1-4613-8404-5_13 · W1023566088
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Conservative endometriosis management preserves reproductive capacity but leads to higher recurrence rates and persistent symptoms compared to definitive surgery.

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This chapter reviews adjunct surgical procedures used in the conservative management of endometriosis, focusing on LUNA (laparoscopic uterine nerve ablation), presacral neurectomy, and uterine suspension, and contrasts these with more definitive surgery that includes hysterectomy and bilateral salpingo-oophorectomy. It summarizes the rationale that preserving reproductive capacity comes with higher recurrence and persistence of symptoms after conservative approaches, and it discusses the reported use of nerve-targeting and uterus-support techniques for pelvic pain syndromes, including studies and controlled data referenced for presacral neurectomy in endometriosis-associated pelvic pain. A key caveat is that the evidence presented across procedures is largely drawn from prior studies with varying designs and outcomes, rather than a single unified trial comparing all methods. This paper is centrally about endometriosis — it specifically addresses adjunctive surgical procedures (LUNA, presacral neurectomy, and uterine suspension) in the conservative treatment context of endometriosis.

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Abstract

Unlike many other diseases of the upper female reproductive tract where total cure involves the removal of part or all of the reproductive organs, endometriosis is generally managed by a variety of more conservative treatments in hopes of preserving reproductive capacity. By accepting this conservative approach, however, endometriosis patients incur higher rates of disease recurrence and persistence of symptoms than with definitive surgery (total abdominal hysterectomy and bilateral salpingo-oophorectomy).1 Preview Unable to display preview. Download preview PDF. Similar content being viewed by others

References

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