Individual patient data meta-analysis of randomized evidence to assess the effectiveness of laparoscopic uterosacral nerve ablation in chronic pelvic pain

J. P. Daniels, L. Middleton, T. Xiong, R. Champaneria, N. P. Johnson, E. M. Lichten, C. Sutton, P. Vercellini, R. Gray, R. K. Hills, K. D. Jones, G. Aimi, K. S. Khan

Research output: Contribution to journalArticlepeer-review

Abstract

Background: There have been conflicting results in randomized trials of the effects of laparoscopic uterosacral nerve ablation (LUNA) in chronic pelvic pain. Our objective was to perform a meta-analysis using individual patient data (IPD) to provide the most comprehensive and reliable assessment of the effectiveness of LUNA. Methods: Electronic searches were conducted in the Medline, Embase, PsycInfo and Cochrane Library databases from database inception to August 2009. The reference lists of known relevant papers were searched for any further articles. Randomized trials comparing LUNA with no additional intervention were selected and authors contacted for IPD. Raw data were available from 862 women randomized into five trials. Pain scores were calibrated to a 10-point scale and were analysed using a multilevel model allowing for repeated measures. RESULTS: There was no significant difference between LUNA and No LUNA for the worst pain recorded over a 12 month time period (mean difference 0.25 points in favour of No LUNA on a 0-10 point scale, 95% confidence interval: -;0.08 to 0.58; P = 0.1). Conclusions: LUNA does not result in improved chronic pelvic pain.

Original languageEnglish
Article numberdmq031
Pages (from-to)568-576
Number of pages9
JournalHuman Reproduction Update
Volume16
Issue number6
DOIs
Publication statusPublished - Jul 15 2010

Keywords

  • Chronic pelvic pain
  • Dysmenorrhoea
  • Individual patient data
  • Meta-analysis
  • Neuroablation

ASJC Scopus subject areas

  • Obstetrics and Gynaecology
  • Reproductive Medicine

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