Other surgical techniques for dealing with chronic pelvic pain include the surgical interruption of nerve pathways. These include laparoscopic uterosacral nerve ablation (LUNA) and presacral neurectomy (PSN).
Studies as far back as the 1930′s do not confirm signficant success rates for techniques such as presacral neurectomy. At best temporary reductions of pain take place over the short term, though there may be occasional situations where it is necessary.
The large LUNA trial in the UK showed no evidence of benefit which is what you might anticipate if you do not know the precise cause of chronic pelvic pain in your population. There are circumstances where the neural injury is confined to the uterosacral ligaments where LUNA may be appropriate. Such circumstances may result from hyperstimulation during induction of labour leading to attenuation of uterosacral ligaments with injuries to the contained nerves. Such decisions depend on knowing precisely the source of pain and its underlying aetiology. Even then cutting the lower half of the uterosacral ligament may result in recurrent pain in due course.
There may be other specific clinical settings where precise knowledge of the limited extent of the neural injury carries a better prognosis.