title: Novel treatment of chronic perineal pain in a woman by extracorporeal shock wave therapy: a case report and published work review.
abstract: In published work review, extracorporeal shock wave therapy (ESWT) has been showed to be effective in treating chronic perineal/pelvic pain in men, but there was no published report on its use in women. We report a case of female chronic perineal pain successfully treated by ESWT. A 51-year-old woman presented with persistent perineal scar pain after excision of a vulval-vaginal nodule despite oral analgesics and gabapentin. After 11 cycles of ESWT, she reported termination of analgesics consumption and decreased perineal pain score from 8 to 2. The Short Form 36 Questionnaire demonstrated improvement in physical and mental health conditions. There was no complication encountered. We postulate that the effect of ESWT in this patient was based on reduction of muscle tone and alternating the threshold of pain memory, similar to the mechanisms in male patients. Further study is required to determine the use of ESWT in treating female chronic perineal pain.
authors.affiliation: Department of Obstetrics and Gynecology, Queen Elizabeth Hospital, HKSAR, China.
authors.forename: Chi Wai
authors.initials: CW
authors.lastname: Tung
authors.forename: Willy Cecilia
authors.initials: WC
authors.lastname: Cheon
authors.forename: Anny
authors.initials: A
authors.lastname: Tong
mesh_terms: D059350:Chronic Pain / Q000628:therapy*; D005260:Female; D019220:High-Energy Shock Waves / Q000627:therapeutic use*; D006801:Humans; D008875:Middle Aged; D010502:Perineum
keywords: irritative condition of pelvic floor; neuromodulation; pelvic pain