Study objective: To describe the modified surgical technique of laparoscopic presacral neurectomy.
Design: A prospective trial (Canadian Task Force classification II-1).
Setting: University hospital.
Patients: Forty-two women with severe midline dysmenorrhea.
Intervention: Laparoscopic modified presacral neurectomy (LMPSN).
Measurements and main results: We designed a prospective study and used a zero-to-10 pain score system to evaluate 42 patients before and after LMPSN. Before surgery, each patient had pain scores ranging from 7 to 10 and had failed medical management. Mean time required to perform LMPSN was 7.33 +/- 1.76 minutes, and most women were discharged the day after surgery. The mean postoperative pain score of 2.02 +/- 2.25 was obtained 6 months after surgery and again at 12 months. No patient had intraoperative or long-term complications.
Conclusion: When a patient requires surgical treatment for chronic midline pelvic pain or severe dysmenorrhea, LMPSN is an alternative choice. It is relatively safe, simple to perform, and satisfactory. This modified surgical procedure appears to increasingly succeed in treatment of midline dysmenorrhea.