Laparoscopic uterine nerve ablation versus vaginal uterosacral ligament resection in postmenopausal women with intractable midline chronic pelvic pain: a randomized study.
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.
Palomba
Stefano
S
Department of Obstetrics & Gynecology, University Magna Graecia of Catanzaro, Catanzaro, Italy. stefanopalomba@tin.it
Russo
Tiziana
T
Falbo
Angela
A
Manguso
Francesco
F
D'Alessandro
Pietro
P
Mattei
Alberto
A
Tolino
Achille
A
Branconi
Francesco
F
Zupi
Errico
E
Zullo
Fulvio
F
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