Surgical approach

A. Many causes of CPP, such as endometriosis, chronic pelvic inflammatory disease, and of a pelvic mass, require a surgical procedure to determine a definitive diagnosis. In addition to providing a diagnosis of endometriosis, surgical excision of the endometriosis implants can be performed during the laparoscopy.

B. Hysterectomy is effective in relieving chronic pelvic pain in some women, who have completed child bearing.

C. Presacral neurectomy refers to interruption of the sympathetic innervation of the uterus. The procedure can be performed via laparoscopy or laparotomy. PSN is most effective for relieving midline pelvic pain.

References: See page 184.

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