Laparoscopic surgery supposedly does not interrupt pelvic nerve connections as opposed to a surgical procedure called as LUNA i.e. laparoscopic uterosacral nerve ablation. The latter apparently did not lead to improvements in chronic pelvic pain, painful menstruation, painful sexual intercourse or quality of life as per a new study.
The authors while providing a context to their study report that, “Chronic pelvic pain in women is as common as asthma and chronic back pain, is one of the most difficult and perplexing of women’s health problems and has a multifactorial etiology. Chronic pelvic pain has a major effect on health-related quality of life, work attendance and productivity, and health care use, accounting for 40 percent of referrals for diagnostic laparoscopy, and is an important contributor to health care expenditures.”
They add, “Treatments for chronic pelvic pain are often unsatisfactory. LUNA was adopted by many practitioners because afferent nerves from pelvic organs pass through the utero-sacral ligament and it was thought that disruption of these would reduce the perceived pain.”
Jane Daniels, M.Sc., from Birmingham Women’s Hospital, University of Birmingham, England and colleagues from the LUNA Trial Collaboration performed a randomized controlled study. It included approximately 487 women with chronic pelvic pain at 18 hospitals in the UK between February 1998 and December 2005 and two groups were formed. Roughly about 243 women underwent the LUNA procedure and laparoscopy without pelvic denervation was given to 244 women. The study participants were sent follow-up questionnaires at three and six months and at one, two, three, and five years.
The results of the analysis showed that the primary outcome may be related to pain and the secondary outcome could be associated with health-related quality of life.
The authors reported “After a median [midpoint] 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.”
No considerable differences were found for noncyclical pain, dysmenorrhea (painful menstruation), or dyspareunia (difficult or painful sexual intercourse). Even for quality of life, there were apparently no differences between the LUNA group and the no LUNA group.
The authors concluded by mentioning that the LUNA trial was designed to assess the effects of LUNA compared with no denervation among women undergoing diagnostic laparoscopy for chronic pelvic pain. LUNA supposedly did not alleviate any type of pain i.e. enoncyclical pain, dysmenorrhea, or dyspareunia or improving the quality of life, irrespective of the presence or absence of mild endometriosis.
This study was published in JAMA.