Architectural Changes in the Medial Gastrocnemius on Sonography after Nerve Ablation in Healthy Adults

Architectural changes in healthy muscle after denervation have not yet been reported. This study aimed to investigate architectural changes in the medial head of the gastrocnemius muscle (GCM) after aesthetic tibial nerve ablation in healthy adults using ultrasonography (US). The effects of tibial nerve ablation were verified by visual observation and surface electromyography analysis. US images of medial GCMs were taken by one trained physician using B-mode and real-time US with a linear-array probe before nerve ablation, at 1 week after nerve ablation and at 3 months after nerve ablation in an anatomic standing position with the feet about shoulder-width apart in 19 healthy adults (17 females and 2 males). Muscle thickness was significantly reduced on the left side at 1 week and 3 months after the procedure and on the right side at 3 months after the procedure (p<0.050). Although fascicle length was not significantly changed, pennation angle was significantly reduced on both sides at 3 months after the procedure (p<0.050). Muscle thickness and pennation angle of the muscle fascicle were significantly reduced, although fascicle length was not significantly changed, after tibial nerve ablation in the medial GCM of healthy adults.

A prospective, double blind randomised controlled trial on efficacy of laparoscopic uterosacral nerve ablation as an alternative of pharmacotherapy in treatment of chronic pelvic pain

Background: Chronic Pelvic Pain (CPP) is one of the commonest symptomatology in gynaecologist’s outpatient clinics. CPP has a profound impact on a woman's health and quality of life, including an economic impact through loss of working hours. Treatment for chronic pelvic pain is often unsatisfactory. Present study compares Laparoscopic Uterosacral Nerve Ablation (LUNA) with laparoscopy without pelvic denervation in patients presenting with chronic pelvic pain to our outpatient clinic.Methods: It was a Randomised Controlled Trial Study. After considering inclusion and exclusion criteria, 120 patients were selected, out of which 60 (Group I) had undergone diagnostic laparoscopy and 60 (Group II) had undergone diagnostic laparoscopy with LUNA.Results: The overall success rate for group I and group II were 80%, 78.3% and 66.6% versus 85%, 81.6%, and 83.3% at 3, 6, and 12 months, respectively. However, on subgroup analysis it was found that in patients suffering from Congestive Dysmenorrhoea, there was a significant difference in success rate of both the groups.Conclusions: It was found in present study that there was a benefit for patients with dysmenorrheal, further research in this area is desirable to reach towards a discrete conclusion regarding the benefits of LUNA in patients of CPP.

The clinical significance of laparoscopic uterosacral nerve ablation (LUNA) in infertile women with pelvic pain and endometriosis / 대한산부인과학회잡지

OBJECTIVE: The aim of this study was to evaluate the efficacy of laparoscopic uterosacral nerve ablation (LUNA) in infertile women with chronic pelvic pain and endometriosis. METHOD: Prospective randomized study was performed in 20 infertile women with endometriosis and chronic pelvic pain, who had undergone of laparoscopic uterosacral nerve ablation at Samsung Cheil hospital between April and September, 1998. Statistical analysis was perfomed using by DBSTAT (ver. 2.0). RESULT: The pelvic pain score of pre-operation was 3.72+/-1.07 (mean+/-SD) and it was significantly decreased to 1.83+/-0.85 at 1 month later and 1.93+/-0.92, 1.69+/-0.60, 1.56+/-0.62, 1.56+/-0.81 each in second, third, fourth and fifth month after operation. There was no correlation between pelvic pain and stage of endometriosis. Pregnancy rate was 65% after LUNA (twelve deliveries, one pregnancy is ongoing at IUP 24 weeks). CONCLUSION: Laparoscopic uterosacral nerve ablation would be effective for infertile women with endometriosis and pelvic pain.

The clinical significance of laparoscopic uterosacral nerve ablation (LUNA) in infertile women with pelvic pain and endometriosis / 대한산부인과학회잡지

OBJECTIVE: The aim of this study was to evaluate the efficacy of laparoscopic uterosacral nerve ablation (LUNA) in infertile women with chronic pelvic pain and endometriosis. METHOD: Prospective randomized study was performed in 20 infertile women with endometriosis and chronic pelvic pain, who had undergone of laparoscopic uterosacral nerve ablation at Samsung Cheil hospital between April and September, 1998. Statistical analysis was perfomed using by DBSTAT (ver. 2.0). RESULT: The pelvic pain score of pre-operation was 3.72+/-1.07 (mean+/-SD) and it was significantly decreased to 1.83+/-0.85 at 1 month later and 1.93+/-0.92, 1.69+/-0.60, 1.56+/-0.62, 1.56+/-0.81 each in second, third, fourth and fifth month after operation. There was no correlation between pelvic pain and stage of endometriosis. Pregnancy rate was 65% after LUNA (twelve deliveries, one pregnancy is ongoing at IUP 24 weeks). CONCLUSION: Laparoscopic uterosacral nerve ablation would be effective for infertile women with endometriosis and pelvic pain.