Paweł Sokal1, Piotr Zieliński2, Marek Harat2. 1. Department of Neurosurgery, The 10th Military Research Hospital, Bydgoszcz, Poland. Electronic address: psokal@wp.pl. 2. Department of Neurosurgery, The 10th Military Research Hospital, Bydgoszcz, Poland.
Abstract
INTRODUCTION: Chronic pelvic pain is a syndrome of chronic non-malignant pain of multifactorial pathophysiology. Perineal, anal and coccygeal pain can be a form of failed-back surgery syndrome or complex regional pain syndrome. Apart from conservative treatment interventional methods are useful in this condition as neurolytic blocks or non-destructive neuromodulation procedures. Peripheral nerve, spinal cord stimulation or sacral stimulation can be applied. AIM: We describe a minimally invasive method of sacral roots stimulation with percutaneous electrodes implanted through the sacral hiatus in the treatment of chronic pelvic pain. MATERIALS AND METHODS: We evaluated a series of nine female patients with pelvic pain treated with sacral roots stimulation in regard of efficacy and complications of this method. RESULTS: Short-term results in all patients were satisfactory with statistically significant improvement (median VAS=9 before surgery) (median VAS=2 after implantation, p=0.001), (median VAS=3 after 6 months, p=0.043). The long-term follow-up revealed less satisfactory result (median VAS=6 after 12 months). High incidence of complications was noted: mainly infection in 3/9 patients. CONCLUSION: Sacral roots stimulation is a non-destructive and minimally invasive neuromodulation method in the treatment of chronic pelvic pain. It can be effective even in the long-term observation but special care is advised to secure aseptic conditions in the implantation and to prevent the infection which leads to removal of the stimulating system.
INTRODUCTION: Chronic pelvic pain is a syndrome of chronic non-malignant pain of multifactorial pathophysiology. Perineal, anal and coccygeal pain can be a form of failed-back surgery syndrome or complex regional pain syndrome. Apart from conservative treatment interventional methods are useful in this condition as neurolytic blocks or non-destructive neuromodulation procedures. Peripheral nerve, spinal cord stimulation or sacral stimulation can be applied. AIM: We describe a minimally invasive method of sacral roots stimulation with percutaneous electrodes implanted through the sacral hiatus in the treatment of chronic pelvic pain. MATERIALS AND METHODS: We evaluated a series of nine female patients with pelvic pain treated with sacral roots stimulation in regard of efficacy and complications of this method. RESULTS: Short-term results in all patients were satisfactory with statistically significant improvement (median VAS=9 before surgery) (median VAS=2 after implantation, p=0.001), (median VAS=3 after 6 months, p=0.043). The long-term follow-up revealed less satisfactory result (median VAS=6 after 12 months). High incidence of complications was noted: mainly infection in 3/9 patients. CONCLUSION: Sacral roots stimulation is a non-destructive and minimally invasive neuromodulation method in the treatment of chronic pelvic pain. It can be effective even in the long-term observation but special care is advised to secure aseptic conditions in the implantation and to prevent the infection which leads to removal of the stimulating system.
Authors: Amr Mahran; Gina Baaklini; Daisy Hassani; Hassan A Abolella; Ahmed S Safwat; Mandy Neudecker; Adonis K Hijaz; Sangeeta T Mahajan; Steven W Siegel; Sherif A El-Nashar Journal: Int Urogynecol J Date: 2019-03-14 Impact factor: 2.894
Authors: David Hao; Alp Yurter; Robert Chu; Mariam Salisu-Orhurhu; Henry Onyeaka; Jon Hagedorn; Kiran Patel; Ryan D'Souza; Susan Moeschler; Alan David Kaye; Vwaire Orhurhu Journal: Pain Ther Date: 2022-09-15