Presacral Neurectomy ‐ A Reappraisal

Fliegner JR, John R. H. FHegner, J R Fliegner, Mark P. Umstad, M P Umstad, Umstad MP
The Australian & New Zealand journal of obstetrics & gynaecology · 1991 · vol. 31(1) , pp. 76–79 · doi:10.1111/j.1479-828x.1991.tb02771.x · PMID:1872780 · W2071050908
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Presacral neurectomy was performed on 20 patients for pelvic pain, resulting in complete cure for 11 (58%) and partial cure for 8 (42%), with the most common indication being secondary dysmenorrhea.

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Abstract

Between April 1984 and April 1990, 20 patients with a mean age of 27.9 years underwent presacral neurectomy at The Royal Women's Hospital, Melbourne, Australia. Overall, 11 of the 19 patients (58%) assessable for follow-up were totally cured of pain and 8 (42%) were partially cured. The most common indication for presacral neurectomy was secondary dysmenorrhoea, usually in association with endometriosis or pelvic adhesions. In 4 patients with uterine dysmenorrhoea not associated with pelvic pathology the operation produced a complete cure. The general consensus of gynaecological opinion is that presacral neurectomy should still be reserved for a limited number of carefully selected patients in whom other methods of treatment have been exhausted. It is imperative that a prior psychological assessment should be undertaken whenever a functional component is suspected. Whilst pain of uterine origin may be cured by presacral neurectomy, lateral pelvic pain of adnexal origin requires ovarian sympathectomy.

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Condition tags

dysmenorrheaendometriosis

MeSH descriptors

Pain Pelvis Sacrum Sympathectomy Adult Dysmenorrhea Dysmenorrhea Dysmenorrhea Endometriosis Endometriosis Female Humans Pain Pain Pelvis Sacrum Sacrum Sympathectomy Uterine Neoplasms Uterine Neoplasms

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