Laparoscopic uterosacral nerve ablation (LUNA) for Endometriosis

Overview
Laparoscopic uterosacral nerve ablation (LUNA) is a surgery to cut the nerves that connect the uterus to the brain to relieve pain associated with endometriosis. LUNA may also be referred to as uterine nerve ablation. LUNA is performed more rarely than presacral neurectomy. Ablation may also be referred to as cauterization.

What does it involve?
Take time choosing your surgeon and hospital. Ask each surgeon you consider how many LUNA surgeries they have performed, and what their rates of success are. Find out details about your surgical options, the procedure involved, recovery time, and the risks and benefits associated with LUNA.

LUNA may be performed during another surgery, such as excision. If it is performed during another surgery, LUNA is usually the final procedure performed. One benefit to receiving LUNA during another surgery is that it is not necessary to receive additional incisions. As a stand-alone surgery, LUNA can be performed through either laproscopy or laparotomy.

During a LUNA surgery, the surgeon cuts the nerves that carry pain signals to the brain. The nerves are located near or within the uterosacral ligaments (fibrous bands that support the uterus).

Intended Outcomes
LUNA surgery is performed to reduce pain associated with endometriosis.

Results
A 2007 article reviewed the results of nine clinical trials studying the effectiveness and safety of LUNA and presacral neurectomy for dysmenorrhea (painful periods). Researchers concluded that there was insufficient evidence to support either procedure and recommended that more studies are needed.

Constraints
Any surgery carries risks including blood clots, blood loss, infection, breathing problems, scarring, reactions to medication, and heart attack or stroke during the surgery. Short-term complications of surgery for endometriosis can include pain in the surgical area, constipation, diarrhea, bladder or vein irritation, nausea, vomiting, fatigue, nightmares, trouble sleeping, headaches, and shoulder pain from gas trapped beneath the diaphragm. Long-term complications can include scarring and adhesions, both of which can affect fertility and necessitate additional surgeries.

Call your doctor if you notice symptoms of infection such as fever, bleeding, swelling, or increased pain at the incision, or severe abdominal cramping and pain. Notify your doctor if you experience chest pain, shortness of breath, discharge from the wound, abnormal or foul-smelling vaginal discharge, pain or swelling in your calves, painful or frequent urination, or vomiting more than 24 hours after the surgery.

LUNA may not be effective in relieving your pain from endometriosis.

The nerves cut or destroyed during LUNA may eventually regrow, causing your pain to return.