title: Resolution of Chronic Vulvar Pruritus With Replacement of a Neuromodulation Device.
abstract: Vulvar pruritus is typically associated with fungal, bacterial, and/or dermatological conditions that routinely resolve with the use of topical medications. Pruritus rarely becomes chronic in nature without a definable pathological diagnosis. However, when this occurs, management is difficult and has limited treatment options. Few cases have reported resolution of vulvar pain or discomfort with sacral neuromodulation implantation. We report a case in which a patient experienced chronic vulvar pruritus that was refractory to medical treatments and did not have a pathological diagnosis. A neurological etiology was suspected, and upon replacement of the patient's sacral neuromodulation device, complete resolution of the vulvar symptoms occurred.
authors.affiliation: Obstetrics/Gynecology and Women's Health Institute, Division of Urogynecology and Pelvic Reconstructive Surgery, Cleveland Clinic Foundation, Cleveland, Ohio. Electronic address: hilla8@ccf.org.
authors.forename: Audra Jolyn
authors.initials: AJ
authors.lastname: Hill
authors.affiliation: Obstetrics/Gynecology and Women's Health Institute, Division of Urogynecology and Pelvic Reconstructive Surgery, Cleveland Clinic Foundation, Cleveland, Ohio.
authors.forename: Marie Fidela R
authors.initials: MF
authors.lastname: Paraiso
mesh_terms: D002908:Chronic Disease; D020878:Device Removal; D004599:Electric Stimulation Therapy / Q000009:adverse effects*; D004567:Electrodes, Implanted / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008160:Lumbosacral Plexus; D008875:Middle Aged; D011539:Pruritus Vulvae / Q000209:etiology / Q000503:physiopathology*; D016896:Treatment Outcome; D001750:Urinary Bladder, Neurogenic / Q000601:surgery*
keywords: Sacral neuromodulation; Vulvar dysesthesia; Vulvar pruritus