Comparison of a new modified laparoscopic presacral neurectomy and conventional laparoscopic presacral neurectomy in the treatment of midline dysmenorrhea

Chun-Hung Chang, Wei‐Chun Chang, Y.C. Hung, Ming‐Chih Ho, Lian Shung Yeh, Wen‐Chuan Lin
In: International Journal of Gynecology & Obstetrics · 2007 · vol. 99(1) , pp. 28–32 · doi:10.1016/j.ijgo.2007.03.016 · PMID:17481632 · W2075331057
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A modified laparoscopic presacral neurectomy showed a significantly lower long-term recurrence rate and no complications compared to conventional surgery for midline dysmenorrhea.

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Abstract

OBJECTIVE: To describe a newly modified laparoscopic presacral neurectomy procedure and to evaluate the long-term benefits of the surgery as a treatment for midline dysmenorrhea. METHOD: Eighty-eight reproductive female patients with midline dysmenorrhea were enrolled in the non-randomized prospective study. There were fifty-five patients in the modified laparoscopic presacral neurectomy (MLPSN) group and thirty-three patients in the conventional laparoscopic presacral neurectomy (LPSN) group. All patients received post-surgery follow-up of more than eight years for evaluation with respect to pain relief, recurrence, and complications. RESULTS: Upon receipt of surgery, the MLPSN and the LPSN groups both demonstrated a significant decrease (P<0.001) in the mean pain score when compared to the pre-surgery mean pain scores. However, the probability of recurrence during the eight years of follow-up was 81.8% (27 patients) in the LPSN group, compared to 43.6% (24 patients) in the MLPSN group, resulting in a significantly lower long-term recurrence rate in the MLPSN group, compared to the LPSN group (P<0.05). No patients in the MLPSN group had long-term complications and one patient had constipation after surgery in the LPSN group. CONCLUSION: The modified laparoscopic presacral neurectomy procedure provides an alternative for those patients who suffer intractable midline dysmenorrhea. This surgery is relatively simple and safe and could result in a satisfactory long-term outcome in the intervention of midline dysmenorrhea.

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dysmenorrhea

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