title: Presacral neurectomy--a reappraisal.
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.
authors.affiliation: Royal Women's Hospital, Melbourne.
authors.forename: J R
authors.initials: JR
authors.lastname: Fliegner
authors.forename: M P
authors.initials: MP
authors.lastname: Umstad
mesh_terms: D000328:Adult; D004412:Dysmenorrhea / Q000209:etiology / Q000601:surgery; D004715:Endometriosis / Q000601:surgery; D005260:Female; D006801:Humans; D010146:Pain / Q000209:etiology / Q000601:surgery*; D010388:Pelvis / Q000294:innervation*; D012447:Sacrum / Q000294:innervation* / Q000601:surgery; D013562:Sympathectomy / Q000379:methods*; D014594:Uterine Neoplasms / Q000601:surgery