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Sacral neuromodulation for pelvic pain and pelvic organ dysfunction: A case series
Author(s) -
Vancaillie Thierry,
Kite Lauren,
Howard Elizabeth,
Chow Jason
Publication year - 2018
Publication title -
australian and new zealand journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.734
H-Index - 65
eISSN - 1479-828X
pISSN - 0004-8666
DOI - 10.1111/ajo.12752
Subject(s) - medicine , neuromodulation , sacral nerve stimulation , pelvic pain , sexual dysfunction , cohort , quality of life (healthcare) , surgery , anesthesia , nursing , stimulation
Background The use of neuromodulation is growing and it is an established therapy for conditions such as bladder dysfunction. It is an increasingly used therapy for the management of chronic perineal pain but little research is currently available looking at its efficacy. Aim We present a series of 52 patients who underwent placement of a neuromodulator, the majority of whom suffered from perineal pain, with most placements via the sacral hiatus. Method Patients were asked to complete a survey recalling their symptoms prior to implantation and describing their symptoms and experience after. The majority had two leads placed via the sacral hiatus. Results Fifty‐two patients had implantation of a permanent neuromodulator and 44 completed at least part of the survey. Forty‐eight had leads placed via the sacral hiatus, 29 of whom had these leads only. Forty patients had perineal pain as an indicator and 32 reported that their pain improved; this difference was statistically significant (95% CI: 2.60–4.27, P < 0.001). Bladder, bowel and sexual dysfunction were reported by about half the cohort with smaller numbers of improvement for each. Thirty‐five patients reported improved quality of life and 32 said they would have the procedure done again. Ten patients had the device removed. Conclusion We present the largest published case series looking at the use of sacral neuromodulation as a treatment option for pelvic pain and the overall results of our audit are promising for the ongoing use and further development of this modality as a management option.