Spinal cord stimulation for intractable vulvar pain. A case report.
BACKGROUND
Vulvodynia is a complex pain syndrome with few effective treatments. We present a case of complex persistent vulvar pain effectively managed with spinal cord stimulation.


METHODS
A 21-year-old woman had a long history of burning vulvar pain exacerbated by exercise and sexual intercourse. Her symptoms began after termination of pregnancy and were not improved by diet changes or medical therapy. A partial vulvar vestibulectomy with Bartholin gland excision was performed, without an improvement. After referral to a pain management specialist, the patient had temporary relief of symptoms following bilateral hypogastric plexus blocks. With these favorable but temporary results, a permanent spinal cord stimulator was implanted, with sustained symptom relief.


CONCLUSIONS
Spinal cord stimulation may offer a new treatment for women with intractable neuropathic vulvar pain.
Whiteside
James L
JL
Departments of Obstetrics and Gynecology and of Pain Management, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195, USA. whitesj1@ccf.org
Walters
Mark D
MD
Mekhail
Nagy
N
D000328:Adult; D004599:Electric Stimulation Therapy; D005260:Female; D006801:Humans; D010148:Intractable Pain / Q000628:therapy*; D013116:Spinal Cord; D014845:Vulvar Diseases / Q000628:therapy*