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September 1, 2014

Laparoscopic surgery does not help pelvic pain

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The surgical procedure LUNA (laparoscopic uterosacral nerve ablation) did not result in improvements in chronic pelvic pain, painful menstruation, painful sexual intercourse or quality of life when compared with laparoscopic surgery that does not interrupt pelvic nerve connections, says a new study.


In the study, doctors conducted a randomised controlled trial of 487 women with chronic pelvic pain at 18 hospitals in the United Kingdom between February 1998 and December 2005. The women were randomised into two groups: 243 women received the LUNA procedure and 244 received laparoscopy without pelvic denervation (no LUNA).
Follow-up questionnaires were sent to study participants at three and six months and at one, two, three and five years. The primary outcome was pain and the secondary outcome was health-related quality of life.
“After a median follow-up of 69 months, there were no significant differences reported on the visual analogue pain scales for the worst pain between the LUNA group and the no LUNA group,” the authors found. There were also no significant differences found for noncyclical pain, dysmenorrhea, or dyspareunia. Also there were no differences observed between the LUNA group and the no LUNA group for quality of life.
In conclusion, the authors reported that LUNA ‘did not alleviate any type of pain – noncyclical pain, dysmenorrhea, or dyspareunia – or improve the quality of life, irrespective of the presence or absence of mild endometriosis’.
JAMA 2009;302:955-961