title: Sacral neuromodulation as a treatment for neuropathic clitoral pain after abdominal hysterectomy.
abstract: Sacral neuromodulation (SNM) may be beneficial in the treatment of patients with chronic pelvic pain, although it is not an FDA-approved indication. We present a case of a 51-year-old patient that presented with symptoms of lower urinary tract dysfunction and clitoral pain after an abdominal hysterectomy. Electrophysiological evaluation suggested a pudendal nerve lesion. After failure of conservative treatment, she was offered SNM as a treatment for her voiding symptoms. During test stimulation, she experienced only moderate improvement in voiding symptoms, but a striking improvement in pain symptoms. She underwent a two-stage implantation of a neurostimulator with a successful outcome after 6 months' follow-up. The results of this report suggest that SNM may be effective in patients with neuropathic pelvic pain.
authors.affiliation: Department of Urology, Maastricht University Medical Center, Maastricht, The Netherlands.
authors.forename: Tom
authors.initials: T
authors.lastname: Marcelissen
authors.forename: Philip
authors.initials: P
authors.lastname: Van Kerrebroeck
authors.forename: Stefan
authors.initials: S
authors.lastname: de Wachter
mesh_terms: D000005:Abdomen; D002987:Clitoris / Q000294:innervation*; D004599:Electric Stimulation Therapy; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects* / Q000379:methods; D008160:Lumbosacral Plexus; D008875:Middle Aged; D009437:Neuralgia / Q000209:etiology* / Q000628:therapy*
references.citation: Int Urogynecol J Pelvic Floor Dysfunct. 2001;12(1):9-14
references.pmid: 11294536
references.citation: J Urol. 2001 Nov;166(5):1742-5
references.pmid: 11586214
references.citation: J Sex Marital Ther. 2002;28 Suppl 1:123-8
references.pmid: 11898694
references.citation: Int Urogynecol J Pelvic Floor Dysfunct. 2008 Apr;19(4):553-7
references.pmid: 17925994