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Post by radeksgrl on May 23, 2007 10:21:11 GMT -5
Hi all,
After lap surgery that offered only partial and temporary pain relief, my physician has recommended another lap, to again clean out the endo and this time including a parasacral neurectomy. There a c couple forms of there nerve severing techniques, uteral sacral nerve ablation, presacral neurectomy (PSN) and the parasacral neurectomy that has been recommended to me. But I really haven’t been able to find much information out there about any of them. Nothing much about possible risks and side effects and nothing at all about any personal experiences from women who have had any of these procedures done as a treatment for endometriosis. I would appreciate any information!
Holly
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Post by ouchy on May 23, 2007 10:56:30 GMT -5
Hi. Welcome to the forum. Please take the time to introduce yourself in the "Instroduce Yourselves" forum. I have not had a neurectomy, nor would I. I judge when I need to have another lap by feeling the pain, so if I couldn't feel the pain and then wound up completely covered in endo, I'd be really mad. Just my opinion for myself. I posted this in another thread, but I'll post it here bc the title of this thread is better! ______________________________________________________________________ Ha!!! I found a good article for you on nerve sevoring/ablating and endometriosis Taken from: www.obgyn.net/women/women.asp?page=/endo/articles/daiter_1204Article by: Dr. Eric Daiter, M.D. "Sensory nerves help to carry the signal of pain to the brain. If there are no sensory nerves functioning in an area of the body then this area is incapable of feeling pain. For example, if the sensory nerves to a person's hand have been destroyed then that person will not be able to "feel" with the hand. If the hand is accidentally hurt (pinched, burned, cut) the affected person may not notice the damage until the damage is sensed via vision. The sensory nerve supply to the pelvis can differ in amount between different women. This is most commonly believed to be the reason why some women have incapacitating pain with minimal endometriosis (lots of nerve endings in the areas of endometriosis) while other women have no pain at all despite massive endometriosis (few nerve endings in the areas of endometriosis). Pelvic organs receive their sensory nerve supply from the autonomic (sympathetic and parasympathetic) nervous system. The sensory innervation of the fallopian tubes, uterus and upper vagina is predominantly via sympathetic fibers at the spinal cord level of T-10 to L-1 (area of the lower back). To reach the spinal cord, nerves from the uterus generally travel through ligaments behind the cervix (the uterosacral ligaments) to a "uterine plexus." Other uterine nerves join other sensory nerves from the pelvis and follow the uterine arteries to an "inferior hypogastric plexus = pelvic plexus" which is at the level of the vagina and rectum. Sensory nerves from the upper vagina, cervix and lower uterus may also travel through parasympathetic nerves to the sacral spine (at S-2 to S-4) via the paracervical "Frankenhauser's plexus." Ovarian sensory nerves travel independently with the ovarian arteries to an "ovarian plexus." Importantly, converging nerve fibers from these networks (that supply the pelvic structures most commonly associated with endometriosis) pass through a common "superior hypogastric plexus = presacral nerve." Surgical transection or removal of the nerves that carry pain sensation from the pelvic structures most commonly associated with endometriosis has been performed for some time. For midline pain, the uterosacral ligament transection (also called "LUNA" = laparoscopic uterine nerve ablation) is occassionally beneficial. For recurring severe pain throughout the pelvis, a presacral nerve ablation (neurectomy) can be considered. I have generally had good results with the aggressive removal of all visible foci of endometriosis. For women with little relief or recurrent endometriosis, the uterosacral ligament transection and presacral nerve ablation can be considered. The serious potential complications with the presacral nerve ablation (neurectomy) have limited the use of this treatment."
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Post by Holly on May 23, 2007 11:54:33 GMT -5
Thanks. My gut reaction was the same, we have pain for a reason, to let us know something it wrong in the area. But it’s always nice to hear someone else say it. Maybe someone who has actually had this procedure will still post their experience.
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Post by ouchy on May 23, 2007 12:08:30 GMT -5
I think we've only had one member whose had it done, and I don't believe she's posted in nearly a year. Sorry. Also, I think I remember something about her doctor not discussing it with her first! He just did it!
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Post by angelas on Jun 6, 2007 20:15:53 GMT -5
Hi there,
I'm not sure if this is what you are talking about, but I had the ligaments to my uterus removed with my second lap to reduce the cramping I was experiencing. It did cut things down a lot for me, but I was still able to feel the pains of things getting worse... I'm just not sure what the medical term is for those ligaments and all that.
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Post by kb on Jun 7, 2007 6:45:14 GMT -5
Oops I answered wrong. Didnt realise what it was till i read the thread and had already said no. I have had this done actually, and it was done without consent. I didnt know the doctor had done it till my post op appointment. It was never discussed before hand. When he told me, i said well it made no difference ive still got pain. He looked at me strange and said it should have helped. He was an ignorant fool. My current specialist when i told him id had that done rolled his eyes. Said yeah, some doctors like to do that, said its an old method and completely useless. For it to have any effect there has to be endo specifically in that area, so if there is any anywhere else it would make no difference whatsoever. If id had a choice, i dont think i would have agreed to that, but i had none. In all honesty though its made no difference, if the docs do it, it wont hurt but its unlikely to help at all. As for needing the pain to know if theres a prob, i agree completely, but considering my experience, i would suggest you would still feel pain if theres a problem in that area and having had the procedure done in the past would make no difference. From the reaction of my current specialist, i would say its as useless as cutting off a finger to help the endo.
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Post by ouchy on Jun 7, 2007 9:30:51 GMT -5
From the reaction of my current specialist, i would say its as useless as cutting off a finger to help the endo. Nice simile!
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Post by cherry on Jun 9, 2007 3:11:25 GMT -5
The fact that some docs do it without consent is so wrong! It's another thing I'll be stipulating at the pre op clinic, that I cannot have a neurectomy because I do not consent! And the fact that it's considered 'old fashioned' but people still do it even when it doesn't really work, that's just wrong xx
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Post by pandagurl on Sept 26, 2007 0:27:02 GMT -5
Hello Ladies,
I am so excited to post this fairly new and exciting information. As outlined in my introduction, I have undergone two lap's without any long term success in pain relief. I have also tried countless different medications.......... and am so sick of all of it! After doing all kinds of research I finally came across something I felt would work for me.
I need something to reduce my pain so I can attempt to live a "normal" life. I also know that even if I have a regular lap only lasering off the endometriosis it would still not help with the horrible menstrual cramps I get every month. I mean, to the point where I land in the hospital because it feels like I'm dying. So finally, I have found something that would take care of all my pain including the endo pain and menstrual pain and quite frankly any other pain that may occur in that area.
These procedures are the best option for me because I still want children and refuse to have any kind of a Hysterectomy as I am only 28yrs old. And if I can't have children of my own then I will at least be in a place where I can foster/adopt. But since I am on all these medications including narcotics there is no way any foster/adoption agency will give me a child! So in my opinion this is truly a great option.
NERVE DESTRUCTION TECHNIQUES:
Laparoscopic Uterosacral Nerve Ablation (LUNA): A recent approach that uses either laser or cauterization to destroy nerves in a small segment of the ligaments that connect the cervix with the lower back. The ligaments do not appear to provide and structural support. There are few side effects from the procedure. The patient does not lose any sensations associated with sexual activity.
Laparoscopic Presacral Neurectomy (LPSN): Uses laser techniques to sever a web of nerves between the lower spine and tail bone that transmit pain from the uterus. The procedure does not affect fertility. This procedure may work better than LUNA in the long term, but it also poses higher complications, including - constipation, diarrhea and urinary problems. However, many women find that these symptoms eventually improve.
I am scheduled for these procedures in combination with the laser removal of the endometriosis. I may also be having some Ovarian Drilling done as well to help me with my PCOS. My GYNO also informed that she will also remove any previous scar tissue from other surgeries as well as anything she finds that does not belong in there.
I am so excited and can't wait. I will then be able to get off a lot of my medications and hopefully function "normally" and move towards having a family!
If you have any questions feel free to email me: squirmygurl@hotmail.com
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Post by kb on Sept 26, 2007 0:43:23 GMT -5
You seem so excited about this so i hate posting this, but feel you should be a bit more informed.
This procedure is not the be all and end all, im sorry to say, it may help, and i really hope it does, but i doubt it.
My endo was on my pelvic wall, right in the area that this was done, and the procedure made absolutely no difference to my pain, except i had a doctor that didnt believe me and wouldnt help me.
The only thing conventional that has helped me is seeing an actual endometriosis specialist, not a fertility doctor, who used an excisional technique rather than laser.
You may feel better after the surgery, but its more likely from everything else done than the nerve cutting.
Do some more research on this before you make your decision, i hope this isnt coming across harsh, i really dont want it to be. I just know it didnt help me and i know what your going through.
I know i sound like a broken record, but i think its always worth looking into natural therapies and diet changes, at least to supplement the other treatments.
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