Long-term effectiveness of presacral neurectomy for the treatment of severe dysmenorrhea due to endometriosis.

STUDY

OBJECTIVE

To assess the long-term effectiveness of presacral neurectomy (PSN) in women with severe dysmenorrhea due to endometriosis treated with conservative laparoscopic surgical intervention.

DESIGN

Randomized, controlled trial (Canadian Task Force classification I).

SETTING

University-affiliated department of obstetrics and gynecology.

PATIENTS: One hundred forty-one sexually active women of reproductive age.

INTERVENTION: Conservative laparoscopic surgery without (group A) or with (group B) PSN.

MEASUREMENTS AND MAIN

RESULTS

At entry and 24-months after surgical procedures, cure rates; frequency and severity of dysmenorrhea, dyspareunia, and chronic pelvic pain; and quality of life were evaluated. At follow-up visit, the cure rate was significantly (P<0.05) higher in group B (83.3%) than in group A (53.3%). The frequency and severity of dysmenorrhea, dyspareunia, and chronic pelvic pain were significantly (P<0.05) lower in both groups compared with baseline values, and only severity was significantly (P<0.05) lower in group B. A significant (P<0.05) improvement in quality of life was observed after surgery in both groups and was significantly (P<0.05) increased in group B compared with group A.

CONCLUSION

PSN improves long-term cure rates and quality of life in women treated with conservative laparoscopic surgery for severe dysmenorrhea due to endometriosis.