Laparoscopic presacral neurectomy: A review

Dysmenorrhea can be a severe and debilitating symptom in many women. Althou gh most women may find adequate relief of symptoms from pharmacological app roaches, there remain a few with resistant pain. Presacral neurectomy, alth ough technically challenging, may be offered after other approaches are uns uccessful. The operation is now performed increasingly by the laparoscopic approach, which has revived this operation in some centers, The anatomy, te chnique, and indications as well as a review of the literature supporting t his operation are reviewed. The potential complications of this operation a re discussed also. Target Audience: Obstetricians & Gynecologists, Family Physicians Learning Objectives: After completion of this article, the reader will be a ble to explain the evolution of presacral neurectomy, define the anatomy of the autonomic nerves of the pelvis, list the indications for presacral neu rectomy, and summarize the data surrounding the presacral neurectomy operat ion.