Interdisciplinary Laparoscopic Implantation of Neuromodulation Leads to the Sacral Plexus for Therapy of Chronic Pelvic Pain and Neurogenic Bladder Dysfunctions

Kołodziej, Małgorzata; Uhl, Eberhard; Schwarm, Frank P.; Nagl, Jasmin; Schürg, R; Meinhold‐Heerlein, Ivo; Tinneberg, Hans‐Rudolf

doi:10.1111/ner.13157

Cited by 8 publications

(17 citation statements)

References 34 publications

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“…Six studies were not included in quantitative analysis 14,21,26,28–30 . Two hundred and sixty patients with CPP across the studies underwent a test phase, 96 were implanted with IPGs.…”

Section: Resultsmentioning

confidence: 99%

“…One study did not report IPG implantation, resulting of an implantation rate of 66.7% across remaining studies. Three studies included a statistical analysis and all reported statistically significant improvement of VAS at last follow‐up 21,26,28 . Improvement in pain score on a 10‐point scale ranged between 1.9 and 6.5.…”

Section: Resultsmentioning

confidence: 99%

“…The WMD in pain score on a 10‐point scale after SNM was −4.64 (95% CI = −5.32 to −3.95, p < 0.00001) (Figure 2). Six studies were excluded from quantitative analysis as they did not report mean ± SD VAS 14,21,26,28–30 . Three of these studies reported a significant decrease in pain score after SNM ( p < 0.05).…”

Section: Resultsmentioning

confidence: 99%

“…Three studies included a statistical analysis and all reported statistically significant improvement of VAS at last follow-up. 21,26,28 Improvement in pain score on a 10-point scale ranged between 1.9 and 6.5. Kessler et al reported a prospective case series of seven CPP patients implanted with an IPG.…”

Section: Primary Outcomementioning

confidence: 99%

“…17 Whitmore, Sokal and Kolodziej found that 100%, 90%, and 66% of participants, respectively either reduced or completely withdrew analgesic medication at last follow-up. 13,24,28 QoL Eleven studies assessed patients' QoL all of which reported improvements in various QoL domains. Eight studies employed the RAND SF-36 health survey questionnaire and six reported individual domains.…”

Section: Secondary Outcomesmentioning

confidence: 99%

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Sacral neuromodulation in the management of chronic pelvic pain: A systematic review and meta‐analysis

Greig

Mak

Furrer

et al. 2023

Neurourology and Urodynamics

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Introduction Sacral neuromodulation (SNM) is a treatment approved for use in several conditions including refractory overactive bladder (OAB) and voiding dysfunction. Chronic pelvic pain (CPP) is a debilitating condition for which treatment is often challenging. SNM shows promising effect in patients with refractory CPP. However, there is a lack of clear evidence, especially in long‐term outcomes. This systematic review will assess outcomes of SNM for treating CPP. Methods A systematic search of MEDLINE, Embase, Cochrane Central and clinical trial databases was completed from database inception until January 14, 2022. Studies using original data investigating SNM in an adult population with CPP which recorded pre and posttreatment pain scores were selected. Primary outcome was numerical change in pain score. Secondary outcomes were quality of life assessment and change in medication use and all‐time complications of SNM. Risk of bias was assessed using the Newcastle Ottawa Tool for cohort studies. Results Twenty‐six of 1026 identified articles were selected evaluating 853 patients with CPP. The implantation rate after test‐phase success was 64.3%. Significant improvement of pain scores was reported in 13 studies; three studies reported no significant change. WMD in pain scores on a 10‐point scale was −4.64 (95% confidence interval [CI] = −5.32 to −3.95, p < 0.00001) across 20 studies which were quantitatively synthesized: effects were maintained at long‐term follow‐up. Mean follow‐up was 42.5 months (0–59). Quality of life was measured by RAND SF‐36 and EQ‐5D questionnaires and all studies reported improvement in quality of life. One hundred and eighty‐nine complications were reported in 1555 patients (Clavien‐Dindo Grade I‐IIIb). Risk of bias ranged from low to high risk. Studies were case series and bias stemmed from selection bias and loss to follow‐up. Conclusion Sacral Neuromodulation is a reasonably effective treatment of Chronic Pelvic Pain and significantly reduces pain and increases patients’ quality of life with immediate to long‐term effects.

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“…Six studies were not included in quantitative analysis 14,21,26,28–30 . Two hundred and sixty patients with CPP across the studies underwent a test phase, 96 were implanted with IPGs.…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Primary Outcomementioning

confidence: 99%