What is the role of laparoscopic uterine nerve ablation (LUNA) in the treatment of endometriosis?

Updated: May 10, 2021
  • Author: G Willy Davila, MD; Chief Editor: Michel E Rivlin, MD  more...
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Nodularity of the uterosacral ligaments may contribute to dyspareunia and low back pain. The transmission of neural pathways is via the Lee-Frankenhäuser plexus. Laparoscopic uterine nerve ablation (LUNA) is performed to interrupt the pain fibers. Potential complications of this procedure include uterine prolapse and pelvic denervation. A systematic review of trials of LUNA found no advantage in terms of pain relief when compared to placebo. [101] However, when combined with laparoscopic ablation, LUNA significantly reduced pain attributed to endometriosis. [57] In patients with subfertility, tissue ablation significantly increased the cumulative pregnancy rate. [61] A Cochrane review failed to show any benefit from either LUNA or presacral neurectomy. [102]

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