Laparoscopic uterine nerve ablation: a survey of gynaecological practice in the UK
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A survey of UK gynecologists found that 45% perform laparoscopic uterine nerve ablation for chronic pelvic pain, endometriosis, or dyspareunia, with 81% willing to join a clinical trial.
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Abstract
Objective To determine the current use of and the indications for laparoscopic uterine nerve ablation (LUNA) in the UK, and to establish practitioners' views regarding the desirability of a controlled clinical trial to assess the efficacy of LUNA. Setting Gynaecologists associated with the British Society of Gynecological Endoscopy. Design A self‐administered structured questionnaire was posted to 457 UK gynaecologists. Their surgical practice and willingness to participate in a randomized trial were surveyed. The postal questionnaire was returned by 249 (55% response rate). Results The survey indicated that 113 (45%) of the responders performed LUNA. Of these, 86 (76%) carried out LUNA for chronic pelvic pain, 72 (64%) for endometriosis, and 16 (14%) for dyspaurenia/dysmenorrhoea. Diathermy was used as the surgical tool by 66 (59%) gynaecologists and laser was used by 57 (51%). Of the 113 currently using LUNA, 91 (81%) were willing to enter patients into a proposed clinical trial of LUNA. Conclusion Current clinical practice regarding LUNA for pelvic pain is hung in equipoise. This means that the technique has been introduced without reliable evidence of efficacy but opinion regarding its use is not yet solidified. Hence, a rigorous randomized trial of LUNA's efficacy is urgently needed and is practicable.
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Cited by (12)
- Laparoscopic Uterine Nerve Ethanol Neurolysis (LUNEN) in Patients with Chronic Pelvic Pain 2016
- Laparoscopic Uterine Nerve Ethanol Neurolysis (LUNEN) in Patients with Chronic Pelvic Pain 2016
- Individual patient data meta-analysis of randomized evidence to assess the effectiveness of laparoscopic uterosacral nerve ablation in chronic pelvic pain 2010
- Laparoscopic Uterosacral Nerve Ablation for Alleviating Chronic Pelvic Pain<subtitle>A Randomized Controlled Trial</subtitle> 2009
- Laparoscopic uterine nerve ablation versus vaginal uterosacral ligament resection in postmenopausal women with intractable midline chronic pelvic pain: A randomized study 2006
- Chronic pelvic pain : prevalence, risk factors and laparoscopic uterosacral nerve ablation. 2006
- Presacral neurectomy for surgical management of pelvic pain associated with endometriosis: A descriptive review 2006
- A randomised controlled trial to assess the efficacy of Laparoscopic Uterosacral Nerve Ablation (LUNA) in the treatment of chronic pelvic pain: The trial protocol [ISRCTN41196151] 2003
- Laparoscopic uterosacral ligament resection for dysmenorrhea associated with endometriosis: results of a randomized, controlled trial 2003
- Laparoscopic uterosacral nerve ablation (LUNA) 2002
- The ovarian endometrioma: why is it so poorly managed?: Indicators from an anonymous survey 2002
- A prospective, randomized, double‐blind controlled trial of laparoscopic uterine nerve ablation in the treatment of pelvic pain associated with endometriosis 2001
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