Individual patient data meta-analysis of randomized evidence to assess the effectiveness of laparoscopic uterosacral nerve ablation in chronic pelvic pain

Jane Daniels, Lee Middleton, Tengbin Xiong, Rita Champaneria, Neil Johnson, E.M. Lichten, Chris Sutton, Paolo Vercellini, Richard Gray, Robert K. Hills, Kevin Jones, Giorgio Aimi, Khalid S. Khan, as the International LUNA IPD Meta-analysis Collaborative Group
In: Human Reproduction Update · 2010 · vol. 16(6) , pp. 568–576 · doi:10.1093/humupd/dmq031 · PMID:20634210 · W2142434343
review OA: bronze CC0 ⤵ 18 in-corpus citations
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An individual patient data meta-analysis of five randomized trials found no significant difference in worst pain over 12 months between laparoscopic uterosacral nerve ablation and no intervention for chronic pelvic pain.

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Abstract

BACKGROUND: There have been conflicting results in randomized trials of the effects of laparoscopic uterosacral nerve ablation (LUNA) in chronic pelvic pain. Our objective was to perform a meta-analysis using individual patient data (IPD) to provide the most comprehensive and reliable assessment of the effectiveness of LUNA. METHODS: Electronic searches were conducted in the Medline, Embase, PsycInfo and Cochrane Library databases from database inception to August 2009. The reference lists of known relevant papers were searched for any further articles. Randomized trials comparing LUNA with no additional intervention were selected and authors contacted for IPD. Raw data were available from 862 women randomized into five trials. Pain scores were calibrated to a 10-point scale and were analysed using a multilevel model allowing for repeated measures. RESULTS: There was no significant difference between LUNA and No LUNA for the worst pain recorded over a 12 month time period (mean difference 0.25 points in favour of No LUNA on a 0-10 point scale, 95% confidence interval: -0.08 to 0.58; P = 0.1). CONCLUSIONS: LUNA does not result in improved chronic pelvic pain.

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