Effectiveness, Safety, and Patient Satisfaction of Laparoscopic Uterosacral Nerve Ablation in Terms of Pain Relief in Women with Chronic Pelvic Pain.

OBJECTIVES

Chronic pelvic pain (CPP) is defined as intermittent or constant pain in the lower abdomen or pelvis for a duration of 6 months that is not exclusively associated with menstruation or sexual intercourse. Laparoscopic ablation of the nerve plexuses and ganglia in the uterosacral ligaments (laparoscopic uterosacral nerve ablation [LUNA]) is a viable treatment option. LUNA, if proven effective, may be a significant treatment amendment as an alternative to surgical therapy. The purpose of our study is to evaluate the efficacy, safety, and patient satisfaction in LUNA in terms of pain relief in women with CPP in whom diagnostic laparoscopy failed to demonstrate an anatomical correlation.

MATERIALS AND

METHODS

In this retrospective observational study, we examined pseudonymized data of women who underwent laparoscopy for chronic pelvic. If there was a pathological correlation for the CPP, LUNA was performed and patients were asked to participated in a postsurgical questionnaire. They were asked about effectiveness, outcome, and satisfaction after LUNA.

RESULTS

The average age of the study population was 25.8 years. All women were premenopausal. When performing LUNA, postoperative pain tolerance improved significantly (P = 0.004). Statistically, the use of painkillers was more frequent before surgery than after (P = 0.015 and P = 0.031). There was a positive trend when asked about social isolation, sexual activity, self-confidence, disgruntlement, and ability to work.

CONCLUSION

In our retrospective study, we were able to show a decrease of pain frequency and pain insensitivity for women with CPP who underwent LUNA. Further prospective randomized, double-blind studies are needed to test if LUNA as a surgical technique is an appropriate treatment option for CPP.