Efficacy of Laparoscopic Pelvic Denervation in Central-Type Chronic Pelvic Pain: A Multicenter Study

ABSTRACT Our aim was to evaluate the efficacy of laparoscopic pelvic denervation (uterosacral resection or presacral neurectomy) for the treatment of chronic pelvic pain with a predominant central-type localization in women with endometriosis or with no visible pathology. In a retrospective analysis performed in six centers, we evaluated the data relative to 58 patients with midline pelvic pain laparoscopically treated, with a follow-up of at least 6 months including a quantitative pain assessment. The distribution of types of pain (dysmenorrhea, deep dyspareunia, and pelvic pain not related to menses or coitus) was not different among stage I–II endometriosis, stage III–IV endometriosis, and no visible pathology, except that deep dyspareunia was significantly (p < 0.05) less frequent in the absence of visible pathology than in moderate to severe endometriosis. Both types of laparoscopic denervations significantly (p < 0.001) reduced after 6 months the intensity of midline dysmenorrhea, pelvic pain, and d...