Pelvic denervation procedures: a current reappraisal.
The introduction of minimally invasive techniques over recent years has led to the resurgence of pelvic denervation procedures such as presacral neurectomy and uterine nerve ablation being performed for women with dysmenorrhea and pelvic pain. Women who have failed medical therapy with persistent and debilitating symptoms may certainly benefit from these procedures. However, presacral neurectomy and uterine nerve ablation are distinct procedures that require appropriate patient selection in order to optimize pain relief. Whereas presacral neurectomy may be effective for both primary dysmenorrhea and endometriosis-related pelvic pain, the role of uterine nerve ablation should be reserved for patients with primary dysmenorrhea only, as evidenced by several randomized trials.
Lee
Ted T M
TT
Division of Gynecologic Specialties, Department of Obstetrics, Gynecology, and Reproductive Sciences, Magee-Womens Hospital, University of Pittsburgh, Pittsburgh, PA, USA. tlee@mail.magee.edu
Yang
Linda C
LC
D003714:Denervation / Q000379:methods*; D004412:Dysmenorrhea / Q000601:surgery*; D004715:Endometriosis / Q000601:surgery; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D019060:Minimally Invasive Surgical Procedures; D017699:Pelvic Pain / Q000601:surgery*; D010388:Pelvis / Q000294:innervation*; D016032:Randomized Controlled Trials as Topic; D012445:Sacrococcygeal Region / Q000294:innervation; D014599:Uterus / Q000294:innervation*