Laparoscopic uterosacral nerve ablation with and without presacral neurectomy in the treatment of primary dysmenorrhea: a prospective efficacy analysis.
OBJECTIVE
To evaluate the efficacy of laparoscopic uterosacral nerve (LUNA) alone vs. LUNA plus presacral neurectomy (PN) in the treatment of primary dysmenorrhea.


METHODS
Seventy-four patients were randomly allocated to LUNA alone or LUNA plus PN. Evaluation of severity of menstrual pain was based on multidimensional scoring.


RESULTS
Sixty-seven patients were eligible for analysis (35 LUNA alone, 32 LUNA plus PN). Baseline demographic features were comparable between the 2 groups. There was no difference between them in the proportion of improvement in dysmenorrhea at 3 months of follow-up (69% for LUNA vs. 73% for LUNA plus PN, p = 0.923), and the results were maintained at 6 and 12 months of follow-up. More surgical complications were found in the LUNA plus PN group.


CONCLUSIONS
For patients with primary dysmenorrhea, LUNA plus PN has no additive therapeutic advantage over LUNA alone, and more surgical complications may be encountered.
Juang
Chi-Mou
CM
Division of General Gynecology, Department of Obstetrics and Gynecology, Veterans General Hospital, and Institution of Epidemiology, College of Public Health, National Yang-Ming University, Taipei, Taiwan. cmjuang@yahoo.com.tw
Chou
Pesus
P
Yen
Ming-Shien
MS
Horng
Huann-Cheng
HC
Twu
Nae-Fong
NF
Chen
Chih-Yao
CY
D000328:Adult; D004412:Dysmenorrhea / Q000601:surgery*; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects / Q000379:methods; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D013562:Sympathectomy / Q000379:methods*; D016896:Treatment Outcome; D014599:Uterus / Q000294:innervation*