Comparison of a new modified laparoscopic presacral neurectomy and conventional laparoscopic presacral neurectomy in the treatment of midline dysmenorrhea.
OBJECTIVE
To describe a newly modified laparoscopic presacral neurectomy procedure and to evaluate the long-term benefits of the surgery as a treatment for midline dysmenorrhea.


METHODS
Eighty-eight reproductive female patients with midline dysmenorrhea were enrolled in the non-randomized prospective study. There were fifty-five patients in the modified laparoscopic presacral neurectomy (MLPSN) group and thirty-three patients in the conventional laparoscopic presacral neurectomy (LPSN) group. All patients received post-surgery follow-up of more than eight years for evaluation with respect to pain relief, recurrence, and complications.


RESULTS
Upon receipt of surgery, the MLPSN and the LPSN groups both demonstrated a significant decrease (P<0.001) in the mean pain score when compared to the pre-surgery mean pain scores. However, the probability of recurrence during the eight years of follow-up was 81.8% (27 patients) in the LPSN group, compared to 43.6% (24 patients) in the MLPSN group, resulting in a significantly lower long-term recurrence rate in the MLPSN group, compared to the LPSN group (P<0.05). No patients in the MLPSN group had long-term complications and one patient had constipation after surgery in the LPSN group.


CONCLUSIONS
The modified laparoscopic presacral neurectomy procedure provides an alternative for those patients who suffer intractable midline dysmenorrhea. This surgery is relatively simple and safe and could result in a satisfactory long-term outcome in the intervention of midline dysmenorrhea.
Chang
C Y Y
CY
Department of Obstetrics and Gynecology, China Medical University Hospital, Taichung, Taiwan.
Chang
W C
WC
Hung
Y C
YC
Ho
M
M
Yeh
L S
LS
Lin
W C
WC
D000293:Adolescent; D000328:Adult; D017763:Autonomic Denervation / Q000009:adverse effects / Q000379:methods*; D003248:Constipation / Q000209:etiology; D004412:Dysmenorrhea / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007001:Hypogastric Plexus / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D010147:Pain Measurement; D011183:Postoperative Complications; D011446:Prospective Studies; D012008:Recurrence; D016896:Treatment Outcome