title: Neurolytic block of ganglion of Walther for the management of chronic pelvic pain.
abstract: Here we report on the use of neurolytic block of ganglion impar (ganglion of Walther) for the management of intractable chronic pelvic pain, which is common enough to be recognized as a problem by gynecologists, likely to be difficult to diagnose and even more challenging to manage. Following failure in controlling the symptoms with pharmacological management, nine women underwent neurolysis of the ganglion impar in our Pain Clinic from 2009 to March 2013. The indication for the procedure was chronic pelvic pain (CPP) of either malignancy-related (4) or other origin (5). The Numeric Rating Scale (NRS) and duration of pain relief were employed to assess effectiveness of the procedure. Neurolysis was efficacious in patients with both malignancy-related CPP and CPP of non-malignant origin. Reported relief time varied from 4 weeks to 3 years, while in 4 cases complete and permanent cessation of pain was achieved. No complications were noted.
authors.affiliation: Department of Anesthesiology and Intensive Care, Medical Center for Postgraduate Education, Warsaw, Poland.
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Malec-Milewska
authors.affiliation: Department of Anesthesiology and Intensive Care, Medical Center for Postgraduate Education, Warsaw, Poland.
authors.forename: Bartosz
authors.initials: B
authors.lastname: Horosz
authors.affiliation: Pain Clinic, Department of Anesthesiology and Intensive Care, Medical Center for Postgraduate Education, Warsaw, Poland.
authors.forename: Iwona
authors.initials: I
authors.lastname: Kolęda
authors.affiliation: Pain Clinic, Department of Anesthesiology and Intensive Care, Medical Center for Postgraduate Education, Warsaw, Poland.
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Sękowska
authors.affiliation: Pain Clinic, Department of Anesthesiology and Intensive Care, Medical Center for Postgraduate Education, Warsaw, Poland.
authors.forename: Hanna
authors.initials: H
authors.lastname: Kucia
authors.affiliation: Department of Anesthesiology and Intensive Care, Medical Center for Postgraduate Education, Warsaw, Poland ; 1 Department of Anesthesiology and Intensive Care, Warsaw Medical University, Warsaw, Poland.
authors.forename: Dariusz
authors.initials: D
authors.lastname: Kosson
authors.affiliation: 1 Department of Obstetrics and Gynecology, Medical Center for Postgraduate Education, Warsaw, Poland.
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Jakiel
keywords: Numeric Rating Scale; chronic cancer pain; chronic pelvic pain; ganglion impar; ganglion of Walther; neurolytic block