The efficacy and complications of laparoscopic presacral neurectomy in pelvic pain

Chen Fang‐Ping, Chen FP, F. P. Chen, Soong YK, Y K Soong
Obstetrics and gynecology · 1997 · vol. 90(6) , pp. 974–977 · doi:10.1016/s0029-7844(97)00484-5 · PMID:9397114 · W1508024325
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Laparoscopic presacral neurectomy provided significant pain relief in over half of patients with various pelvic pain conditions, with few major complications but frequent manageable constipation.

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Abstract

OBJECTIVE: To evaluate the efficacy and complications of laparoscopic presacral neurectomy in pelvic pain. METHODS: We reviewed records of 655 patients receiving laparoscopic conservative surgery and laparoscopic presacral neurectomy for diagnoses including adenomyosis with dysmenorrhea (n = 55), moderate and severe endometriosis with dysmenorrhea (n = 127), minimal and mild endometriosis with dysmenorrhea (n = 208), primary dysmenorrhea (n = 99), and chronic pelvic pain with or without pathologic disease (n = 166). Pain relief was evaluated at least 12 months postoperatively. RESULTS: Pain relief was evaluated in 527 patients. Significant pain relief (no pain or mild pain requiring no medication) was found in 22 (52%) of 42 women with adenomyosis, in 75 (73%) of 103 with moderate to severe endometriosis with dysmenorrhea, in 123 (75%) of 164 with minimal to mild endometriosis with dysmenorrhea, in 64 (77%) of 83 with primary dysmenorrhea, and in 84 (62%) of 135 with chronic pelvic pain. There were four major complications (0.6%) that required further surgery, including injury of the right internal iliac artery (n = 1) and chylous ascites (n = 3). Three cases (0.5%) had laceration of the middle sacral vein controlled during laparoscopy. In addition, 485 (74%) of the 655 patients complained of constipation after laparoscopic presacral neurectomy, which was relieved easily by medication. CONCLUSION: Presacral neurectomy can be performed safely and efficiently by laparoscopy and is a valuable alternative treatment for pelvic pain.

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Condition tags

dysmenorrheaendometriosischronic_pelvic_painadenomyosis

MeSH descriptors

Denervation Denervation Dysmenorrhea Endometriosis Hypogastric Plexus Laparoscopy Laparoscopy Pelvic Pain Adolescent Adolescent Adult Adult Chronic Disease Chronic Disease Denervation Denervation Dysmenorrhea Dysmenorrhea Endometriosis Endometriosis

Citation neighborhood (2-hop)

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. Outer rings show 2-hop neighbours — papers reached through the immediate citers/citees. [ collapse to 1-hop ]

References (15)

Cited by (48)

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