Sacral Nerve Stimulation for Treatment of Perineal Pain
Sergey A. Karasev, MD | Alexander E. Yakovlev, MD | Beth E. Resch, APNP
BACDKGROUND AND AIMS
Perineal pain is a common complaint for women during the peak of their reproductive years, comprising approximately 10% of visits to gynecologists per year. Sacral nerve stimulation (SNS) is a well established treatment option for voiding dysfunction refractory to conservation therapies. The aim of this study was to evaluate the use of SNS for a patient with chronic perineal pain.
MATERIALS AND METHODS
The patient was a 32-year-old female with a 4-year history of constant perineal pain, worse with sexual intercourse, following vaginal delivery who had minimal relief from conservative therapies including medication management, physical therapy, pudendal nerve block and ganglion impar block. She underwent successful trial placement of two 8-electrode standard Octad leads (Medtronic Inc., Minneapolis, MN) placed in the epidural space percutaneously through the sacral hiatus with final lead electrodes positioned between S1 and S4 (Figure 1). During the 3-day SNS trial the patient reported greater than 50% improvement in pain and two weeks later underwent implantation with permanent leads and RestoreULTRA (Medtronic Inc., Minneapolis, MN) rechargeable generator.
RESULTS
After final implantation the patient reported significant pain relief (>80% reduction in VAS) with permanent stimulator. She was able to discontinue use of opioid pain medications and continued on pregabalin at reduced doses. The patient reported other positive outcomes including adequate pain relief during sexual intercourse.
FIGURES
CONCLUSION
SNS may be a therapeutic alternative for patients with chronic perineal pain who in the past exhausted all available treatments.
© 2018 Клиника «МЕДЭЛЕКТ»
г. Москва, Спартаковский пер, д.2 стр. 5.
Телефон: (499) 281-61-47