title: Effectiveness of presacral neurectomy in women with severe dysmenorrhea caused by endometriosis who were treated with laparoscopic conservative surgery: a 1-year prospective randomized double-blind controlled trial.
abstract: OBJECTIVE
  The purpose of this study was to assess the effectiveness of presacral neurectomy in women with severe dysmenorrhea caused by endometriosis that was treated with conservative surgical intervention.
  
  
  METHODS
  One hundred forty-one sexually active women of fertile age with chronic severe dysmenorrhea caused by endometriosis were treated with conservative laparoscopic surgery. Patients were assigned randomly to not receive (group A) or receive (group B) presacral neurectomy. At 6 and 12 months after the surgical procedures, the cure rate was evaluated in each patient. The frequency and severity of dysmenorrhea, dyspareunia, and chronic pelvic pain were also evaluated at the same time intervals.
  
  
  RESULTS
  The cure rate was significantly higher in group B compared with group A at a follow-up examination at 6 months (87.3% vs 60.3%) and 12 months (85.7% vs 57.1%). At follow-up visits, the frequency and severity of dysmenorrhea, dyspareunia, and chronic pelvic pain were significantly lower in both groups compared with baseline values; in particular, significantly lower values were observed in group B versus group A for the severity.
  
  
  CONCLUSIONS
  Presacral neurectomy improves the cure rate in women who are treated with conservative laparoscopic surgery for severe dysmenorrhea caused by endometriosis.
authors.affiliation: Departments Obstetrics and Gynecology, the University "Magna Graecia" of Catanzaro, the University of Rome, Catanzaro, Rome.
authors.forename: Fulvio
authors.initials: F
authors.lastname: Zullo
authors.forename: Stefano
authors.initials: S
authors.lastname: Palomba
authors.forename: Errico
authors.initials: E
authors.lastname: Zupi
authors.forename: Tiziana
authors.initials: T
authors.lastname: Russo
authors.forename: Michele
authors.initials: M
authors.lastname: Morelli
authors.forename: Fulvio
authors.initials: F
authors.lastname: Cappiello
authors.forename: Pasquale
authors.initials: P
authors.lastname: Mastrantonio
mesh_terms: D000328:Adult; D003714:Denervation / Q000379:methods*; D004311:Double-Blind Method; D004412:Dysmenorrhea / Q000209:etiology / Q000601:surgery*; D004414:Dyspareunia / Q000601:surgery; D004715:Endometriosis / Q000150:complications*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects; D017699:Pelvic Pain / Q000601:surgery; D010388:Pelvis / Q000294:innervation*; D011183:Postoperative Complications / Q000453:epidemiology; D011446:Prospective Studies; D016896:Treatment Outcome