If this is true, however, there are two procedures that can be done to reduce or eliminate the dysmenorrhea in a significant number of patients, without resorting to hysterectomy. The uterosacral ligaments are two of the main support structures of the uterus, securing the base of the uterus at the top of the cervix to the tailbone, or sacrum. Through these ligaments travel the main nerve supply to the uterus and cervix, including the fibers that carry sensation back to the brain, where they are recognized as pain. The LUNA procedure involves the cutting of these nerves laparoscopically using lasers or electrocautery. Several studies have shown approximately 60 to 70 percent of women report a significant reduction or elimination in their dysmenorrhea.
Presacral neurectomy is a procedure that has been around for several years.
Performed during open surgery for the treatment of dysmenorrhea, the nervous supply to the pelvic organs in cut higher up, on the sacrum. Approximately 70 to 80 percent of women report significant improvement in their dysmenorrhea. LPSN is more difficult and more risky than LUNA, because the nerves run close to the major blood supply to the legs and pelvis. Instead of a complete hysterectomy, removal of the diseased side may be curative, and since the other ovary remains, the natural hormone production will continue. The uterus also remains, but if it is not the cause of the problem, then there is no need for a hysterectomy.