Chronic pelvic pain remains a huge problem with a dramatic effect on womens lives. Operative interruption of nerve trunks in the uterosacral ligaments by laparoscopic uterosacral nerve ablation (LUNA) was thought to be a treatment option for these patients.

This multicentre, single blinded, trial randomised 487 women with chronic pelvic pain to either receive the LUNA procedure (bilateral pelvic denervation) or not (laparoscopy with no pelvic denervation) and assessed the effectiveness of this procedure in alleviating pain. Women with chronic pelvic pain lasting longer than 6 months with or without minimal endometriosis, adhesions, or pelvic inflammatory disease were recruited by gynaecologists from UK hospitals between February 1998 and December 2005. Follow-up questionnaires were sent out to patients at 3 and 6 months, and 1,2,3,5 and 10 years after randomisation.

The primary outcome measure was the worst type of pain reported (dysmenorrhea, dyspareunia, non-cyclical pain), which was assessed using the visual analogue scale (VAS). Quality of life was a secondary outcome, measured using EuroQoL EQ-5D Information on sexual activity and resource usage was also collected

There was no significant difference between LUNA and No LUNA for dysmenorrhoea (mean difference over time -0·04cm on the 10cm VAS, 95%CI -0·45 to 0·37; p=0·8), for dyspareunia (0·02,  -0·45 to 0·45; p=0·9), for non-cyclical pain (-0·29, -0·70 to 0·12; p=0·2) nor for the worst pain reported at any time point (-0·04, -0·43 to 0·35; p=0·8).

The trial concluded that the LUNA procedure was not effective in treating women with chronic pelvic pain.

The paper is available at http://jama.ama-assn.org/cgi/content/full/302/9/955

If any investigators or other interested parties would like a copy of the paper but does not have a subscription to JAMA, please email r.champaneria@bham.ac.uk and a link will be sent out to you in order for you to download the paper.