Sacral Nerve Stimulation in Patients With Refractory Pudendal Neuralgia.
Pain Physician
; 25(4): E619-E627, 2022 07.
Article
em En
| MEDLINE
| ID: mdl-35793186
ABSTRACT
BACKGROUND:
Pudendal neuralgia (PN) is one of the most common forms of genital pain. Only 42.2% of PN patients respond to the first-line treatment. Novel neuromodulation techniques in the treatment of refractory PN patients are urgently required.OBJECTIVES:
The aim of this study was to evaluate the treatment effects and adverse events of sacral nerve stimulation (SNS) for patients with refractory PN. STUDYDESIGN:
A prospective nonrandomized study.SETTING:
This prospective analysis included 33 patients who received the phase II surgical implantation.METHODS:
A total of 55 eligible PN patients were recruited for SNS treatment after informed consent, and 33 of 55 patients with a minimum 50% improvement were candidates for surgical implantation. Visual Analog Scale (VAS) scores, Self-rating Anxiety and Depression Scale, Quality of life score (SF-36), and sleep monitoring indicators before and after surgery were used to assess the effects of SNS on patients with refractory PN.RESULTS:
Thirty-three patients were included in the final analysis, involving 24 women and 9 men with a mean age of 49.5 years (26-70 years). There was a favorable decrease in pain severity (VAS scores) from 7.1 ± 1.1 at baseline to 6.1 ± 1.0 on postoperative day 1, and 2.8 ± 0.7 at 1 week, 1.7 ± 0.5 at 1 month, 1.1 ± 0.7 at 6 months, and 1.0 ± 0.6 at 12 months after surgery, respectively (P < 0.05). The mean score of each section of SF-36 after SNS was significantly higher than that at baseline (P < 0.05). Total sleep time and sleep time in each period were significantly prolonged after SNS implantation compared with that before surgery (6 months vs Pre, total 5.32 ± 1.49 hours vs 3.66 ± 1.19 hours, deep 2.52 ± 0.63 hours vs 1.36 ± 0.43 hours, light 1.78 ± 0.42 hours vs 0.99 ± 0.30 hours, rapid eye movement 1.41 ± 0.29 hours vs 0.89 ± 0.27 hours, P < 0.05). No serious device complications were reported during the follow-up period.LIMITATIONS:
Large-scale randomized clinical trials are warranted to evaluate the risk factors for prediction of refractory PN.CONCLUSIONS:
These data imply that SNS can have beneficial effects on patients with refractory PN.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Terapia por Estimulação Elétrica
/
Neuralgia do Pudendo
Idioma:
En
Ano de publicação:
2022
Tipo de documento:
Article