title: Presacral Neurectomy for Treatment of Midline Pelvic Pain: Laparoscopic Approach with Laparoscopic Treatment of a Single Major Complication
abstract: The treatment of midline dysmenorrhea and pelvic pain with laparoscopic presacral neurectomy (LPSN) has been reported previously. In this prospective study, 27 women experienced severe midline dysmenorrhea/pain, and 12 of these women also had significant lateral pain. Other procedures including lysis of adhesions, excision/vaporization of endometriosis, and appendectomy were completed prior to LPSN. Twenty-two women reported no midline pain in follow-up 5 to 35 months postoperatively, 4 noted significant reduction of midline pain, and 1 had persistence of severe pain. Of the 12 women with lateral and midline pain, 3 had persistence of pain. Laparoscopic repair of a left common iliac vein laceration was accomplished with hemoclips. This report supports the view that LPSN is a safe and effective procedure for treating midline dysmenorrhea/pelvic pain when performed by experienced laparoscopic surgeons. Selected complications may be managed laparoscopically.
authors.affiliation: The Advanced Surgery Center at Candler Hospital, 5354 Reynolds Street, Suite 518, Savannah, GA 31405.
authors.initials: ED
authors.lastname: Biggerstaff
authors.initials: S
authors.lastname: Foster