Laparoscopic uterosacral nerve block: A fertility preserving option in chronic pelvic pain

Benjamin P Jones; Srdjan Saso; Timothy Bracewell-Milnes; Jen Barcroft; Jane Borley; Teodor Goroszeniuk; Kostas Lathouras; Joseph Yazbek; J Richard Smith; Benjamin P Jones; Srdjan Saso; Timothy Bracewell-Milnes; Jen Barcroft; Jane Borley; Teodor Goroszeniuk; Kostas Lathouras; Joseph Yazbek; J Richard Smith

doi:10.3934/medsci.2019.4.260

AIMS Medical Science

2019, Volume 6, Issue 4: 260-267. doi: 10.3934/medsci.2019.4.260

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Case report

Laparoscopic uterosacral nerve block: A fertility preserving option in chronic pelvic pain

1.
West London Gynecological Cancer Centre, Hammersmith Hospital, Imperial College NHS Trust, London W12 OHS, UK
2.
Department of Surgery and Cancer, Imperial College London, Du Cane Road, London W12 0NN, UK
3.
The Lister Hospital, Chelsea Bridge Road, London SW1W 8RH, UK

Received: 31 July 2019 Accepted: 17 September 2019 Published: 26 September 2019

Chronic pelvic pain (CPP) can cause extreme physical distress in women and has widespread socio-economic consequences. Nerve root blocks have become a safe and effective treatment modality in multiple specialties in both the diagnosis and treatment of pain. We describe a novel technique of a laparoscopic uterosacral nerve block (USNB) and demonstrate its effectiveness in the treatment of a complex case of CPP. USNB has potential diagnostic, prognostic and therapeutic implications. It should therefore be considered as part of the multi-disciplinary management of women with CPP of suspected uterine origin such as adenomyosis, degenerating fibroids or following myomectomy.
- chronic pelvic pain,
- nerve block,
- laparoscopy,
- fertility preservation,
- adenomyosis
Citation: Benjamin P Jones, Srdjan Saso, Timothy Bracewell-Milnes, Jen Barcroft, Jane Borley, Teodor Goroszeniuk, Kostas Lathouras, Joseph Yazbek, J Richard Smith. Laparoscopic uterosacral nerve block: A fertility preserving option in chronic pelvic pain[J]. AIMS Medical Science, 2019, 6(4): 260-267. doi: 10.3934/medsci.2019.4.260

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Abstract

Chronic pelvic pain (CPP) can cause extreme physical distress in women and has widespread socio-economic consequences. Nerve root blocks have become a safe and effective treatment modality in multiple specialties in both the diagnosis and treatment of pain. We describe a novel technique of a laparoscopic uterosacral nerve block (USNB) and demonstrate its effectiveness in the treatment of a complex case of CPP. USNB has potential diagnostic, prognostic and therapeutic implications. It should therefore be considered as part of the multi-disciplinary management of women with CPP of suspected uterine origin such as adenomyosis, degenerating fibroids or following myomectomy.

Acknowledgments

The authors would like to thank Dee Mclean for providing the artwork for Figure 3.

Conflict of interest

All authors declare no conflicts of interest in this paper.

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