The Pain Cycle: Implications for the Diagnosis and Treatment of Pelvic Pain Syndromes

Everaert, Karel; Devulder, Jacques; M, De Muynck; Stockman, Sharon; Depaepe, H; D, De Looze; J, Van Buyten; Oosterlinck, W

doi:10.1007/s001920170087

Cited by 88 publications

(60 citation statements)

References 7 publications

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“…Everaert et al 55 also treated a series of chronic pelvic pain and reported that success was inversely related to neuropathic pain, but that the 11 patients who responded appeared to have a durable response to ϳ3 years. A subsequent series of 21 implanted patients with interstitial cystitis, reported by Peters and Konstandt, 56 were followed for a mean of 15 months.…”

Section: Figmentioning

confidence: 99%

Sacral Nerve Stimulation: Neuromodulation for Voiding Dysfunction and Pain

Mayer

Howard

2008

Neurotherapeutics

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Summary:Voiding dysfunction, which includes incontinence, retention, and chronic pelvic pain, is a relatively frequent problem that can be difficult to manage. Neuromodulation via stimulation of the sacral nerves has been shown to improve thesesymptoms, although the exact mechanisms remain elusive. Techniques for nerve stimulation may vary, depending on the disease, location of pain, and the patient's anatomy. In addition to placement of electrodes on the sacral nerve roots, modulation has also been reported by peripheral branches of the sacral nerves including the pudendal and posterior tibial nerves. Newer surgical techniques have significantly decreased the morbidity of the procedures and increased the probability of a successful outcome.

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Section: Figmentioning

confidence: 99%

Sacral Nerve Stimulation: Neuromodulation for Voiding Dysfunction and Pain

Mayer

Howard

2008

Neurotherapeutics

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“…10 Promising results are being reported in conditions, such as pelvic pain syndrome and interstitial cystitis. [11][12][13][14][15] Few papers reported the effect of SNM therapy on female sexual function in mixed population groups with voiding dysfunction, fecal incontinence, 16 and chronic pelvic pain. [17][18] It is uncertain if the reported effect of SNM therapy in female sexual function is direct to stimulation or secondary to primary disease therapy and overall improved quality of life.…”

Section: Introductionmentioning

confidence: 99%

Effect of sacral neuromodulation on female sexual function and quality of life: Are they correlated?

Banakhar

Gazwani²,

Kelini³

et al. 2014

CUAJ

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Cite as: Can Urol Assoc J 2014;8(11-12):e762-7. http://dx.doi.org/10.5489/cuaj.2300 Published online November 24, 2014. AbstractIntroduction: Sacral neuromodulation (SNM) has become an established therapy for voiding dysfunction. Additional benefits, such as improved bowel functions and bladder pain, have been reported. Improvement in female sexual function after SNM treatment has been suggested; however, reports examining the effects of SNM on female sexual functions are scarce. We evaluate the effects of SNM on female sexual function and its impact on quality of life and analyze any correlation. Methods: Data were collected from January 2010 to May 2012 for all female patients who underwent SNM InterStim (Medtronic, Minneapolis, MN) therapy at a single centre in Canada. They were treated for voiding dysfunction, including refractory overactive bladder, frequency-urgency syndrome and non-obstructive urinary retention. Patients were screened by percutaneous nerve evaluation (PNE) to assess their response to therapy using a 4-day voiding diary. Patients who experienced 50% or more improvement in their voiding parameters were permanently implanted. All patients completed the Female Sexual Function Index (FSFI), Short-Form Health Survey (SF-36), and incontinence questionnaires (Urinary Distress Inventory [UDI]-6) preoperatively and 4 months postoperatively. Results: A total of 33 female patients had SNM therapy; 10 were excluded from the study because they were not sexually active. The indications were: refractory overactive bladder in 19, frequencyurgency syndrome in 2, and non-obstructive urinary retention in another 2 patients. SNM therapy significantly improved the total FSFI score (p = 0.011); the components of desire and orgasm showed significant improvement (p = 0.014 and p = 0.035, respectively). Age, body mass index, diagnosis, and urinary symptoms did not show significant correlation with FSFI score improvement. Quality of life showed significant improvement after SNM treatment in 5 categories. There was no correlation between improvement in quality of life and FSFI. Conclusion: SNM may improve female sexual function and quality of life, yet there is no correlation between the improvement in FSFI and quality of life.

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“…Everaert et al [23], treating a series of chronic pelvic pain, reported that success was inversely related to neuropathic pain, but that the 11 patients who responded appeared to have a lasting response up to 3 years. In both case seriers a continuous SNM was used for therapy resistant pain.…”

Section: Discussionmentioning

confidence: 99%

“…Though the exact pathogenesis of CPPS remains unknown, in these patients pelvic floor hyperactivity and pelvic congestion are a common phenomenon [23,25].…”

Section: Discussionmentioning

confidence: 99%

Cycling Sacral Root Neuromodulation: Pilot Study to Assess the Effectiveness of This Mode in Neuromodulator Programming for the Treatment of Chronic Pelvic Pain Syndrome

Cappellano¹,

Ciotti²,

Tafuri³

et al. 2017

Med Surg Urol

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Aim: There is lack of evidence of the role of sacral root neuromodulation (SNM) in the management of chronic pelvic pain syndrome (CPPS). We evaluated the effectiveness of cycling sacral root neuromodulation (CSNM) in the management of CPPS in patients non responders to conservative treatment. Methods:A prospective, single center, cohort study was carried out on all patients with CPPS refractory to conventional treatment, who underwent test stimulation using the tined lead between February 2012 and March 2016. During test stimulation the tine lead was positioned along the third sacral nerve, on the side where they reported more pain. Success was defined as >50% improvement of pain and concurrent urinary symptoms. After a successful SNM test period of 4 weeks, patients received a permanent implant. We also included 9 more patients already with a permanent implant and partial responders to continuous mode in neuromodulator programming. To assess pain and quality of life, all patients filled-in a VAS scale and SF-36 and McGill questionnaires, at baseline, after the 4-week test period ad after the permanent implant.Results: Overall 22 consecutive adult patients were suitable to undergo a cycling test stimulation; 19 out of them (86.3%) underwent a permanent implant after a satisfactory test phase, using a codified cycling mode of programming. Eighteen naive patients out of nineteen (94.7%) maintained the benefits of the test stimulation at a mean follow up of 21.3 months. VAS scale, McGill and SF-36 questionnaires scores improved significantly in all domains with a 95% satisfaction rate; 7 out of the 9 already implanted patients (77.7%) significantly improved their pain control.Conclusion: CSRN appears to be effectiveness in treating CPPS in both naïve and previous implanted partial responder patients.

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The Pain Cycle: Implications for the Diagnosis and Treatment of Pelvic Pain Syndromes

Cited by 88 publications

References 7 publications

Sacral Nerve Stimulation: Neuromodulation for Voiding Dysfunction and Pain

Sacral Nerve Stimulation: Neuromodulation for Voiding Dysfunction and Pain

Effect of sacral neuromodulation on female sexual function and quality of life: Are they correlated?

Cycling Sacral Root Neuromodulation: Pilot Study to Assess the Effectiveness of This Mode in Neuromodulator Programming for the Treatment of Chronic Pelvic Pain Syndrome

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