Another surgical approach popularized in the 1990s is the sectioning of sympathetic
and parasympathetic nerves in the presacral or uterosacral/uterine junction. The theory behind these
treatments hinges on afferent pain fibers traveling in these autonomic nerves in the pelvic; if they are
interrupted, pain should be eliminated or reduced. One such procedure is Laparoscopic Uterosacral Nerve
Ablation (LUNA), which consists of cutting the uterosacral nerve pathways as it enters the uterus. This
intervention is difficult for surgeons and involves significant risk of urinary and digestive side effects secondary
to nerve damage. Additionally, a randomized controlled trial in 2009 found that among women with chronic
pelvic pain, LUNA did not result in improvements in pain, dysmenorrhea, dyspareunia, or quality of life
compared with laparoscopy without pelvic denervation.