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Presacral neurectomy is where the nerves that come out of the uterus are cut. Presacral neurectomies have been done since 1899 in an effort to relieve uterine cramping with a menstrual flow. They are approximately 75% effective. The combination of a presacral neurectomy and excision of the endometriosis would represent the maximum amount of conservative surgery that can be done for pain. Presacral neurectomies do not have any effect on getting pregnant, staying pregnant or having children. There is a very low rate of decreased sensation of bladder fullness, but patients do not lose urine, get more infections or seem to have any difficulties with actual bladder function. There is a very low rate of the possibility of increased constipation, although many patients report a decrease in constipation after the procdure is done. However, many patients describe no changes in their bowel or bladder function.
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