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Paracervical uterine denervation by transection of the cervical plexus for the relief of dysmenorrhea

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      Abstract

      • 1.
        1. The transection of the cervical division of the Lee-Frankenhäuser uterovaginal plexus lying in, around, and under the terminal 2.5 cm. of the uterosacral ligaments permits sensory denervation of the cervix and fundus of the uterus and the proximal segment of the tubes.
      • 2.
        2. The procedure may be done during laparotomy or culdotomy.
      • 3.
        3. Neuromuscular and neurovascular autonomic imbalance is avoided since both sympathetic and parasympathetic pathways are interrupted.
      • 4.
        4. Relief of acquired dysmenorrhea with or without antecedent primary dysmenorrhea was obtained satisfactorily in 69 of 73 cases (94.5 per cent). The relief was complete in 63 cases (86.3 per cent); in 30 of 35 aggravated primary dysmenorrhea cases (85.7 per cent); in 33 of 38 acquired secondary dysmenorrhea cases (86.8 per cent). Relief was partial in 6 cases (8.2 per cent). There were four failures (5.5 per cent).
      • 5.
        5. There was no interference with the function of the bladder or rectum.
      • 6.
        6. The regrowth of the nerves is prevented by the interposition of the posterior parametrial peritoneum between the transected uterosacral ligaments and the top of the vagina.
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