Abstract
Background: Whether laparoscopic uterosacral nerve ablation (LUNA) can lessen the severity of menstrual pain is still a matter of debate. This study tried to evaluate the impact of LUNA on patients who had menstrual migraine. Materials and Methods: A retrospective study was conducted. Between 1993 and 2002, 258 consecutive patients underwent LUNA for the treatment of dysmenorrhea. The primary outcome measure was the rate of improvement of menstrual migraine among those patients who underwent LUNA evaluated by headache score. The secondary outcome measure was the difference between LUNA responders and LUNA nonresponders at baseline, 3, 6, and 12 months from surgery. Clinically relevant improvement in menstrual migraine was defined as a 25% or greater improvement on headache score at 3 months' postoperative follow-up from baseline. Results: Of the 258 patients who underwent LUNA, 39 (15.1%) patients had concurrent menstrual migraine. After LUNA, 10 (25.6%) patients had clinically relevant improvement in headache score. Thirty-nine (39) patients were further subdivided into LUNA responders and LUNA nonresponders. For LUNA responders, there was significant improvement in headache score 12 months after LUNA than it was at baseline (mean difference = 28, 95% confidence interval [CI] = 23–38; p = 0.001). For LUNA nonresponders, there was no significant improvement in headache score 12 months after LUNA than it was at baseline (mean difference = 4, 95% CI=−3–6; p = 0.525). Conclusions: Menstrual migraine may be better alleviated in LUNA responders than LUNA nonresponders. (J GYNECOLOGIC SURG 22:97)
Published Version
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