AI Article Synopsis
- Refractory genitourinary pain is challenging to treat, with conditions like orchalgia and interstitial cystitis being common examples; this study evaluates the effectiveness of oral gabapentin, an anticonvulsant, for such pain.
- In a study of 21 patients (9 men and 12 women) with refractory pain, gabapentin was administered at doses ranging from 300 to 2,100 mg/day, and pain levels were assessed before and after 6 months of treatment.
- Results showed that 10 out of 21 patients reported pain relief, particularly those with interstitial cystitis, indicating gabapentin's potential role in treating difficult genitourinary pain cases, despite some side effects like
Article Abstract
Purpose: Refractory genitourinary pain is a common but difficult condition to treat. Examples of chronic genitourinary pain include orchalgia, interstitial cystitis, pain after bladder suspension surgery, nonbacterial prostatitis, and genital pain related to lumbosacral neuropathy. We report our experience with oral gabapentin treatment for this condition. Gabapentin is an anticonvulsant with unclear but therapeutic effects on neurologic pain.
Materials And Methods: Twenty-one patients referred with refractory genitourinary pain were treated with oral gabapentin. There were 9 men and 12 women. In the male patients, the location of pain was testicle (4), bladder (2), penis (1), or prostate (2). In female patients, the pain was located in the urethra (4), bladder (6), vulva (1), or vagina (1). The dose of gabapentin was titrated from 300 up to 2,100 mg/day. Subjective pain severity and 10-cm visual pain scale was used before and 6 months after therapy.
Results: The mean dose of gabapentin was 1,200 mg/day (range 300-2,100 mg). Ten of 21 patients reported subjective improvement of their pain. The remaining patients did not perceive any improvement. Gabapentin was well tolerated; only 4 patients dropped out due to side effects. The most common adverse effects were dizziness and drowsiness. Five of 8 patients with interstitial cystitis reported improvement.
Conclusions: Although only 10 of 21 patients improved with gabapentin, this cohort included only patients with refractory genitourinary pain that failed a wide range of prior treatments. Gabapentin belongs in the armaterium of the urologist who treats genitourinary pain.
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