ABSTRACT
Several chapters in this textbook consider procedures directed at pathology believed to contribute to pelvic pain (see Chapter 9 on Endometriosis, Chapter 10 on Adhesiolysis, and Chapter 14 on Presacral Neurectomy). This chapter will review additional procedures used to combat pelvic pain. The first, laparoscopy under local anesthesia/conscious sedation, is used to map the pain and attempt to determine the potential for surgical and medical intervention. The second, laparoscopic uterosacral nerve ablation/resection, is an attempt to alter the transmission pathway of pain from the central pelvis. Finally, uterine suspension is a procedure used to alter anatomic relationships in an attempt to reduce a specific type of pain: dyspareunia. These procedures will be reviewed in detail in terms of their indications, methodology, and rates of success.
