Medical Health Encyclopedia

There is some evidence that when the pain-conducting nerve fibers leading from the uterus are surgically severed, the amount of pain from dysmenorrhea diminishes. Two procedures, uterine nerve ablation and laparoscopic presacral neurectomy, are used to block such nerves. Small studies have shown benefits from these procedures, but stronger evidence is needed before they can be recommended for women with severe primary dysmenorrhea.

Uterine Nerve Ablation. Uterine nerve ablation techniques use either laser or cauterization to destroy the nerves leading from the uterus to the lower part of the spine. It has been successful in some cases.

Laparoscopic Presacral Neurectomy. Laparoscopic presacral neurectomy uses laser techniques to sever the nerves in the lower back that transmit pain from the uterus. The procedure does not affect fertility. One study reported pain relief of 80% and over in about 46% of women and pain reduction by 50% to 80% in over 36% of them. The effects seem to be more long lasting than with uterine nerve ablation.

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Complications include constipation, diarrhea, and urinary problems. (It should be noted, however, that these symptoms improve after the procedure in as many women.) Although injury can occur during the procedure, it is uncommon.