Sacral neuromodulation as a treatment for neuropathic clitoral pain after abdominal hysterectomy.
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.
Marcelissen
Tom
T
Department of Urology, Maastricht University Medical Center, Maastricht, The Netherlands.
Van Kerrebroeck
Philip
P
de Wachter
Stefan
S
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*
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