Presacral neurectomy is a surgical treatment that may be used for rare cases of severe dysmenorrhea that cannot be resolved by medications or other means. Essentially it involves cutting the nerves that transmit the signal of pain from the uterus to the brain. The procedure can be performed either by open abdominal surgery (laparotomy) or with minimally invasive laparoscopic surgery. Cutting these nerves does not affect sexual response, the ability to become pregnant or the ability to have a normal vaginal delivery. However, it does not provide relief for all women and should be considered a treatment of last resort for menstrual pain. It may cause chronic constipation and urinary problems as a consequence of destruction of nerve tissue.
- Parker WH. A Gynecologist’s Second Opinion. 2003; A Plume Book; Published by the Penguin Group, New York, NY.