Superior Hypogastric Plexus Pulsed Radiofrequency Combined With Posterior Tibialis Nerve Transcutaneous Radiofrequency As A Treatment Option Of Chronic Pelvic Pain Management In Interstitial Cystitis

Abstract

Purpose To compare the effectiveness of superior hypogastric plexus pulsed radiofrequency (SHP-PRF) and adjunctive transcutaneous posterior tibial nerve stimulation (TPTNS) in the treatment of patients with interstitial cystitis (IC). Methods Patients diagnosed with IC and performed SHP-PRF treatment were included in this retrospective study. Some of these patients had also undergone TPTNS. Group 1 consisted of patients receiving SHP-PRF and TPTNS treatment. Group 2 consisted of patients receiving SHP-PRF treatment. Patients were evaluated before the interventional procedure and in the 1st and 3rd months after the procedure. Numerical rating scale (NRS), neuropathic pain 4 questions (DN4), the O'Leary-Sant interstitial cystitis symptom index (ICSI), and interstitial cystitis problem index (ICPI) were used as evaluation parameters. Results A total of 34 patients were divided into two groups. In both groups, the results showed significant differences in the NRS, DN4, ICSI, and ICPI scores between the baseline and the 1st month, as well as between the baseline and the 3rd month. (p < 0.01). NRS, DN4, and ICPI scores at baseline, 1st, and 3rd months were similar between the groups (p > 0.05). The median of the ICSI score at baseline was significantly higher in group 1 (p < 0.01), but ICSI scores in 1st and 3rd months were not significantly different (p > 0.05) Conclusion SHP-PRF treatment is a minimally invasive and effective method that can be used to reduce the symptoms and severity of IC. However, the effectiveness of adding TPTNS to the treatment could not be demonstrated. Long-term follow-up, prospective and placebo-controlled studies are needed. CTR number: NCT06256679, registration date: 05.02.2024, retrospectively registered.