title: Management of Urinary and Fecal Incontinence in Patients With Complex Regional Pain Syndrome.
abstract: BACKGROUND
  Urinary voiding dysfunction is reported in many patients with complex regional pain syndrome (CRPS). However, there is a gap in the literature for treating patients with CRPS who develop incontinence symptoms.
  
  
  METHODS
  We report a case describing the use of sacral neuromodulation therapy in a patient with urgency urinary and fecal incontinence who had a previously implanted spinal cord stimulator for type 1 CRPS, formerly known as reflex sympathetic dystrophy. Despite initial hesitation and treatment delay, sacral neuromodulation therapy was successful and effective in controlling both fecal and urgency urinary incontinence symptoms for the patient. This intervention continues to provide her with an improved quality of life 10 months after her procedure.
  
  
  CONCLUSIONS
  In this case, there was significant hesitation from the provider and patient to use invasive treatments for incontinence symptoms when the patient's pain symptoms have been well controlled with an existing spinal device. However, in this patient with type 1 CRPS, even in the setting of an existing spinal cord stimulator, sacral neuromodulation therapy was an effective treatment.
authors.affiliation: From the *Obstetrics Gynecology & Reproductive Biology, Harvard Medical School; and †Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA.
authors.forename: Rui
authors.initials: R
authors.lastname: Wang
authors.forename: Roger
authors.initials: R
authors.lastname: Lefevre
mesh_terms: D020918:Complex Regional Pain Syndromes / Q000150:complications / Q000628:therapy*; D004599:Electric Stimulation Therapy / Q000295:instrumentation / Q000379:methods*; D005242:Fecal Incontinence / Q000209:etiology / Q000628:therapy*; D005260:Female; D006801:Humans; D058542:Implantable Neurostimulators; D008875:Middle Aged; D012447:Sacrum / Q000294:innervation; D062187:Spinal Cord Stimulation / Q000295:instrumentation / Q000379:methods; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000209:etiology / Q000628:therapy*