Presacral Neurectomy
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Presacral Neurectomy
Presacral neurectomy is one of the treatments for chronic pelvic pain and dysmenorrhea. Lapraroscopic presacral neurectomy is an initial surgical intervention for chronic pelvic pain when medical therapy fails. __TOC__ Mechanism The sensory pathways from the pelvic viscera pass through the superior hypogastric plexus and inferior hypogastric plexus to the spinal columns. The excision of presacral nerve trunk results in the obstruction of the pain pathway from the hypogastric plexi to the spinal cord. Presacral neurectomy denervates the uterus and causes loss of some bladder sensation. Efficacy Presacral neurectomy is offered to patients for whom medical therapy for chronic pain relief has failed. The efficacy of the procedure is around 75-80%. Less than 1% of all patients have major complications following the surgery. References

{{reflist Abdominal surgical procedures Gynecological surgery Pain management ...
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Dysmenorrhea
Dysmenorrhea, also known as period pain, painful periods or menstrual cramps, is pain during menstruation. Its usual onset occurs around the time that menstruation begins. Symptoms typically last less than three days. The pain is usually in the pelvis or lower abdomen. Other symptoms may include back pain, diarrhea or nausea. Dysmenorrhea can occur without an underlying problem. Underlying issues that can cause dysmenorrhea include uterine fibroids, adenomyosis, and most commonly, endometriosis. It is more common among those with heavy periods, irregular periods, those whose periods started before twelve years of age and those who have a low body weight. A pelvic exam and ultrasound in individuals who are sexually active may be useful for diagnosis. Conditions that should be ruled out include ectopic pregnancy, pelvic inflammatory disease, interstitial cystitis and chronic pelvic pain. Dysmenorrhea occurs less often in those who exercise regularly and those who have childre ...
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Superior Hypogastric Plexus
The superior hypogastric plexus (in older texts, hypogastric plexus or presacral nerve) is a plexus of nerves situated on the vertebral bodies anterior to the bifurcation of the abdominal aorta. Structure From the plexus, sympathetic fibers are carried into the pelvis as two main trunks- the right and left hypogastric nerves- each lying medial to the internal iliac artery and its branches. The right and left hypogastric nerves continues as Inferior hypogastric plexus; these hypogastric nerves send sympathetic fibers to the ovarian and ureteric plexuses, which originate within the renal and abdominal aortic sympathetic plexuses. The superior hypogastric plexus receives contributions from the two lower lumbar splanchnic nerves (L3-L4), which are branches of the chain ganglia. They also contain parasympathetic fibers which arise from pelvic splanchnic nerve (S2-S4) and ascend from Inferior hypogastric plexus; it is more usual for these parasympathetic fibers to ascend to the left-hand ...
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Inferior Hypogastric Plexus
The inferior hypogastric plexus (pelvic plexus in some texts) is a network () of nerves that supplies the organs of the pelvic cavity. The inferior hypogastric plexus gives rise to the prostatic plexus in males and the uterovaginal plexus in females. The inferior hypogastric plexus is a paired structure, meaning there is one on the left and the right side of the body. These are located on either side of the rectum in males, and at the sides of the rectum and vagina in females. For this reason, injury to this structure can arise as a complication of pelvic surgeries and may cause urinary dysfunction and urinary incontinence. Testing of bladder function is used in that case to show a poorly compliant bladder, with bladder neck incompetence, and fixed external sphincter tone. Structure The plexus is formed from: * a continuation of the superior hypogastric plexus on either side, at the Sacrum Promontory in the interiliac triangle. At this location, the presacral nerve sits in the mi ...
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Abdominal Surgical Procedures
The abdomen (colloquially called the belly, tummy, midriff, tucky or stomach) is the part of the body between the thorax (chest) and pelvis, in humans and in other vertebrates. The abdomen is the front part of the abdominal segment of the torso. The area occupied by the abdomen is called the abdominal cavity. In arthropods it is the posterior tagma of the body; it follows the thorax or cephalothorax. In humans, the abdomen stretches from the thorax at the thoracic diaphragm to the pelvis at the pelvic brim. The pelvic brim stretches from the lumbosacral joint (the intervertebral disc between L5 and S1) to the pubic symphysis and is the edge of the pelvic inlet. The space above this inlet and under the thoracic diaphragm is termed the abdominal cavity. The boundary of the abdominal cavity is the abdominal wall in the front and the peritoneal surface at the rear. In vertebrates, the abdomen is a large body cavity enclosed by the abdominal muscles, at front and to the sid ...
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Gynecological Surgery
Gynecological surgery refers to surgery on the female reproductive system usually performed by gynecologists. It includes procedures for benign conditions, cancer, infertility, and incontinence. Gynecological surgery may occasionally be performed for optional or cosmetic purposes, such as hymenoplasty or labiaplasty Labiaplasty (also known as labioplasty, labia minora reduction, and labial reduction) is a plastic surgery procedure for altering the labia minora (inner labia) and the labia majora (outer labia), the folds of skin surrounding the human vulva. T .... Gynecologic Procedures Following are different types of Gynecologic Procedures- * Cervical Cryosurgery * Colposcopy * Dilation and Curettage (D&C) * Hysteroscopy * LEEP Procedure * Pelvic Laparoscopy Gynecologic Procedures Gynecological surgery includes: * Removal of ovarian cyst * surgical contraception, and * Hysterectomy Technology Development With the advancement of technology there has been rob ...
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