Laparoscopic uterine nerve ablation: a survey of gynaecological practice in the UK

Objective To determine the current use of and the indications for laparosco pic uterine nerve ablation (LUNA) in the UK, and to establish practitioners ' views regarding the desirability of a controlled clinical trial to assess the efficacy of LUNA. Setting Gynaecologists associated with the British Society of Gynecological Endoscopy. Design A self-administered structured questionnaire was posted to 457 UK gy naecologists. Their surgical practice and willingness to participate in a r andomized trial were surveyed. The postal questionnaire was returned by 249 (55% response rate). Results The survey indicated that 113 (45%) of the responders performed LUN A. Of these, 86 (76%) carried out LUNA for chronic pelvic pain, 72 (64%) fo r endometriosis, and 16 (14%) for dyspaurenia/dysmenorrhoea. Diathermy was used as the surgical tool by 66 (59%) gynaecologists and laser was used by 57 (51%). Of the 113 currently using LUNA, 91 (81%) were willing to enter p atients into a proposed clinical trial of LUNA. Conclusion Current clinical practice regarding LUNA for pelvic pain is hung in equipoise. This means that the technique has been introduced without re liable evidence of efficacy but opinion regarding its use is not yet solidi fied. Hence, a rigorous randomized trial of LUNA's efficacy is urgently nee ded and is practicable.