Presacral neurectomy for chronic pelvic pain

Area of Science:

• Gynecology
• Pain Management
• Surgical Procedures

Background:

• Chronic pelvic pain (CPP) significantly impacts quality of life.
• Medical management often fails to provide adequate relief for CPP.
• Presacral neurectomy is a surgical option for refractory CPP.

Purpose of the Study:

• To evaluate the efficacy of presacral neurectomy for chronic pelvic pain.
• To assess the impact of adding bilateral uterosacral ligament resection.
• To determine recurrence rates and complications associated with the procedure.

Main Methods:

• Retrospective review of 50 presacral neurectomies performed over eight years.
• Pain assessment using a 0-10 scale for dysmenorrhea, dyspareunia, and other pelvic pain.
• 45 patients completed pre- and post-operative questionnaires.

Main Results:

• Successful pain relief rates: 73% for dysmenorrhea, 77% for dyspareunia, 63% for other pelvic pain.
• No significant difference in success rates with the addition of uterosacral ligament resection.
• 18% recurrence rate for lateral pelvic pain; no recurrence of dysmenorrhea.
• Complication rate of 4%.

Conclusions:

• Presacral neurectomy is an effective treatment for chronic pelvic pain, particularly dysmenorrhea and dyspareunia.
• The addition of bilateral uterosacral ligament resection does not enhance surgical outcomes.
• The procedure demonstrates a favorable safety profile with manageable recurrence rates.