Chronic pelvic pain : prevalence, risk factors and laparoscopic uterosacral nerve ablation.

Pallavi Latthe
2006 · W169024146
dissertation OA: green CC0
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This thesis investigates chronic pelvic pain by summarizing its prevalence, exploring risk factors, examining beliefs about laparoscopic uterosacral nerve ablation, and outlining a protocol for a randomized controlled trial.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 ⓘ

This thesis studied the prevalence and risk factors for chronic pelvic pain (CPP), clinicians’ practice patterns and beliefs about laparoscopic uterosacral nerve ablation (LUNA), and the evidence for neuroablation through systematic reviews, questionnaires, and development of a multicentre randomized controlled trial protocol. It estimated CPP-related symptom prevalence via systematic review/meta-analysis and identified associations between factors such as age, BMI, smoking, menarche/bleeding characteristics, parity, psychological variables, and conditions like pelvic inflammatory disease with different CPP pain types, while also reporting that rates varied substantially due to non-representative samples and inadequate study methods. In addition, surveys showed European and UK differences in surgical technique and operator experience, and the LUNA evidence work found LUNA to be better than control/no treatment for primary dysmenorrhoea at 12 months but found presacral neurectomy (PSN) to be more effective; it also reported that adding LUNA to surgical treatment of endometriosis did not improve pain relief for secondary dysmenorrhoea and that PSN had more adverse events. This paper is centrally about endometriosis and adenomyosis only insofar as endometriosis was listed as an LUNA indication (60%) and was included in analyses of secondary dysmenorrhoea alongside laparoscopic surgical treatment of endometriosis, while adenomyosis is not mentioned.

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Abstract

This thesis sheds light on chronic pelvic pain in following areas: 1. Summarising prevalence of chronic pelvic pain 2. Exploring the risk factors in chronic pelvic pain, 3. Exploring beliefs on laparoscopic uterosacral nerve ablation and 4. Developing a protocol for a Multicentre randomised controlled trial of laparoscopic uterosacral nerve ablation.

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chronic_pelvic_pain

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