Laparoscopic uterosacral nerve ablation and chronic pelvic pain.

Chronic pelvic pain is a complicated syndrome comprised of different types of pain, including dysmenorrhea, deep dyspareunia, and intermenstrual pain, which can make interpretation difficult. Therefore, investigation of this complex syndrome requires very careful consideration. Accumulating data from several randomized studies, we have now come to realize that LUNA can be an option in a few circumstances, especially for control of menstrual pain without endometriosis; however, its effectiveness may not extend to other indications, such as alleviating secondary dysmenorrhea associated with endometriosis (although it could, however, be reached by presacral neurectomy). Juang et al's article reports a very preliminary experience in the treatment of primary deep dyspareunia, presenting a promising perspective yet without sufficient evidence on the management of deep dyspareunia. A randomized controlled study with an adequate number of patients is warranted.