The role of laparoscopic presacral neurectomy for the treatment of choronic pelvic pain

Objective To investigate the efficacy and safety of l ap aroscopic presacral neurectomy (LPSN) as the surgical treatment of chronic midli ne pelvic pain and dysmenorrhea. Methods Sixteen women, age 25 to 46 years, who experienced severe pelvic pain and/or dysmenorrhea; 7 of 16 had s ignificant chronic pelvic inflammatory disease and other 9 patients had endometr iosis.All patients were performed laparoscopic presacral neurectomy.Other proced ures, including lysis of adhesions, excision and vaporization of endometriosis, and subtotal hysterectomy were completed as adjuncts to LPSN.Results All patients underwent technically successful laparoscopic presacral neurec tomy without intraoperative and postoperative complications.Average operating ti me was 41 min(30～55min)and average blood loss was 58ml (30～80)ml respectively. Me an postoperative hospital stay was 4.5d.Follow-up 3 to 12 months after surgery, 13 patients reported no midline pain, two had significant reduction of pain, and one had persistence of severe pain.Conclusion Presacral neurecto my can be performed safely and efficiently by laparoscopy and is a valuable alte rnative treatment for pelvic pain.