Long-term effectiveness of presacral neurectomy for the treatment of severe dysmenorrhea due to endometriosis.
OBJECTIVE
To assess the long-term effectiveness of presacral neurectomy (PSN) in women with severe dysmenorrhea due to endometriosis treated with conservative laparoscopic surgical intervention.


METHODS
Randomized, controlled trial (Canadian Task Force classification I).


METHODS
University-affiliated department of obstetrics and gynecology.


METHODS
One hundred forty-one sexually active women of reproductive age.


METHODS
Conservative laparoscopic surgery without (group A) or with (group B) PSN.


RESULTS
At entry and 24-months after surgical procedures, cure rates; frequency and severity of dysmenorrhea, dyspareunia, and chronic pelvic pain; and quality of life were evaluated. At follow-up visit, the cure rate was significantly (P<0.05) higher in group B (83.3%) than in group A (53.3%). The frequency and severity of dysmenorrhea, dyspareunia, and chronic pelvic pain were significantly (P<0.05) lower in both groups compared with baseline values, and only severity was significantly (P<0.05) lower in group B. A significant (P<0.05) improvement in quality of life was observed after surgery in both groups and was significantly (P<0.05) increased in group B compared with group A.


CONCLUSIONS
PSN improves long-term cure rates and quality of life in women treated with conservative laparoscopic surgery for severe dysmenorrhea due to endometriosis.
Zullo
Fulvio
F
Department of Obstetrics and Gynecology, University Magna Graecia, Catanzaro, Italy.
Palomba
Stefano
S
Zupi
Errico
E
Russo
Tiziana
T
Morelli
Michele
M
Sena
Teresa
T
Pellicano
Massimiliano
M
Mastrantonio
Pasquale
P
D000328:Adult; D003714:Denervation / Q000379:methods*; D004412:Dysmenorrhea / Q000209:etiology / Q000601:surgery*; D004414:Dyspareunia / Q000209:etiology / Q000601:surgery; D004715:Endometriosis / Q000150:complications* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy; D017699:Pelvic Pain / Q000209:etiology / Q000601:surgery; D010388:Pelvis / Q000294:innervation*; D011788:Quality of Life; D016037:Single-Blind Method; D016896:Treatment Outcome