NEW YORK (Reuters Health) - For women who have severe pelvic pain during menstruation, but don't have endometriosis, relief may be possible with keyhole surgery to destroy nerves coming from the uterus, according to a study in New Zealand.

The procedure is known as laparoscopic uterine nerve ablation (LUNA). It is a "reasonable option in the group in whom we showed effectiveness, but other non-surgical options should perhaps be considered first," Dr. Neil P. Johnson from the University of Auckland told Reuters Health.

Johnson and his colleagues studied the effectiveness of LUNA for chronic pelvic pain in 123 women; 56 of them had no evidence of endometriosis while 67 did have the condition. Endometriosis is an overgrowth of tissue lining the uterus, sometimes at other sites in the pelvis, and is often painful.

Among women with no endometriosis, significantly more who underwent LUNA reported a 50 percent or greater reduction in pain 12 months later than did women not having the procedure, the authors report in the September issue of British Journal of Obstetrics and Gynecology.

LUNA had no significant effect, however, for women with endometriosis or non-menstrual pelvic pain.

The team says this is "no surprise." The operation disrupts only some of the nerve fibers in the pelvis, so "LUNA may be less effective for pelvic pain associated with more extensive pelvic pathology."

Only one in four women "really seem to benefit," Johnson said.

He recommends LUNA for "women with no endometriosis in whom dysmenorrhea is debilitating and (is) the major symptomatic component, where conservative and medical options have been unsuccessful." That is to say, as a last resort.

"Don't do LUNA for women with endometriosis," Johnson stressed. "The population of women for whom it is indicated is much smaller than we once believed."

SOURCE: British Journal of Obstetrics and Gynaecology, September 2004.

• More news on Pain
• More news on Women's Health Issues

Related MedlinePlus Pages:

• Menstruation
• Pain
• Women's Health Issues