title: Laparoscopic uterine nerve ablation versus vaginal uterosacral ligament resection in postmenopausal women with intractable midline chronic pelvic pain: a randomized study.
abstract: OBJECTIVE
  To assess and compare the laparoscopic uterine nerve ablation (LUNA) and the vaginal uterosacral ligament resection (VUSR) in postmenopausal women with chronic pelvic pain (CPP).
  
  
  METHODS
  Eighty postmenopausal women with intractable and severe midline CPP were randomized to undergo LUNA or VUSR. Costs of two surgical procedures were assesses. Cure rate, severity of CPP, and deep dyspareunia were also evaluated after 6 and 12 months from surgery.
  
  
  RESULTS
  The mean cost of LUNA resulted significantly higher in comparison with VURS (2078+/-637 versus 1497+/-297, P<0.001). The cure rate was not significantly different between the two groups at 6 (33/40, 82.5% versus 35/40, 87.5% for groups A and B, respectively; P=0.530; RR 0.94, 95% CI 0.78-1.13), and 12 months (27/36, 75.0% versus 28/38, 73.7%, for groups A and B, respectively; P=0.901; RR 0.90, 95% CI 0.78-1.33) of follow-up. At same times, a significant (P<0.01) decrease in severity of CPP and deep dyspareunia was observed in both groups with no difference between them.
  
  
  CONCLUSIONS
  Both LUNA and VUSR are equally effective surgical treatments in postmenopausal women with central CPP but VUNR is significantly cheaper than LUNA.
authors.affiliation: Department of Obstetrics & Gynecology, University Magna Graecia of Catanzaro, Catanzaro, Italy. stefanopalomba@tin.it
authors.forename: Stefano
authors.initials: S
authors.lastname: Palomba
authors.forename: Tiziana
authors.initials: T
authors.lastname: Russo
authors.forename: Angela
authors.initials: A
authors.lastname: Falbo
authors.forename: Francesco
authors.initials: F
authors.lastname: Manguso
authors.forename: Pietro
authors.initials: P
authors.lastname: D'Alessandro
authors.forename: Alberto
authors.initials: A
authors.lastname: Mattei
authors.forename: Achille
authors.initials: A
authors.lastname: Tolino
authors.forename: Francesco
authors.initials: F
authors.lastname: Branconi
authors.forename: Errico
authors.initials: E
authors.lastname: Zupi
authors.forename: Fulvio
authors.initials: F
authors.lastname: Zullo
mesh_terms: D020884:Colpotomy / Q000009:adverse effects / Q000191:economics / Q000379:methods; D004414:Dyspareunia / Q000601:surgery; D005260:Female; D017048:Health Care Costs; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000191:economics / Q000379:methods*; D008022:Ligaments / Q000601:surgery*; D008875:Middle Aged; D017699:Pelvic Pain / Q000601:surgery*; D010525:Peripheral Nerves / Q000601:surgery; D017698:Postmenopause; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014599:Uterus / Q000294:innervation