Aims: In patients with pudendal neuralgia, prior studies have shown efficacy in chronic stimulation with Interstim® (Medtronic, Inc.). This feasibility study reports on the initial experience of using a wireless system to power an implanted lead at the pudendal nerve, StimWave®, to treat pudendal neuralgia.
Methods: Retrospective chart review identified patients with a lead placed at the pudendal nerve for neuralgia and powered wirelessly. Clinical outcomes were assessed at Postoperative visits and phone calls. Administered non-validated follow-up questionnaire evaluated the Global Response Assessment, percentage of pain improvement, satisfaction with device, and initial and current settings of the device (h/day of stimulation).
Results: Thirteen patients had the StimWave® lead placed at the pudendal nerve, 12 (92%) female and 1 (7.6%) male. Mean age was 50 years (range: 20-58). Failed prior therapies include medical therapy (100%), pelvic floor physical therapy (92%), pudendal nerve blocks (85%), pelvic floor muscle trigger point injections (69%), neuromodulation (30.7%), or surgeries for urogenital pain (23.1%). After the trial period, 10/13 (76.9%) had >50% improvement in pain with 6/13 (46.1%) reporting 100% pain improvement. Nine underwent permanent lead placement. At last postoperative visit (range, 6-83 days), 5/9 patients reported >50% pain improvement. Seven patients reached for phone calls (22-759 days) reported symptoms to be "markedly improved" (n = 2), "moderately improved" (n = 4), or "slightly improved" (n = 1). At follow up, complications included lead migration (n = 2), broken wire (n = 1), or nonfunctioning antenna (n = 2).
Conclusion: Complex patients with pudendal neuralgia may benefit from pudendal nerve stimulation via StimWave®.
Download full-text PDF |
Source |
---|---|
http://dx.doi.org/10.1002/nau.24735 | DOI Listing |
Am J Gastroenterol
November 2024
Division of Neurogastroenterology/Motility, Medical College of Georgia, Augusta University, Augusta, Georgia.
Anorectal neuropathy causes anorectal dysfunction, yet it is poorly recognized. This stems from both a lack of understanding of the extrinsic and intrinsic innervation of the anorectum and tools for evaluation of neuronal function. Our objective was to provide an improved understanding of the neuronal networks of the anorectum and discuss its functional significance.
View Article and Find Full Text PDFNeurogastroenterol Motil
December 2024
Department of Surgery, Anorectal Physiology Laboratory, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
Normal anal sensibility can be present in ARM patients diagnosed with all types of ARM after they have been treated with corrective surgery. Anal sensibility was better in those with a functional IAS. This means that the IAS, present in the distal end of the fistula, should be spared as much as possible to preserve anal sensibility.
View Article and Find Full Text PDFUrogynecology (Phila)
October 2024
From the Urology Institute, University Hospitals/ Cleveland Medical Center, Cleveland, OH.
Importance: Evidence regarding the effect of pudendal nerve blockade during vaginal surgery is conflicting. Previous studies compared pudendal nerve blockade to either normal saline placebo injection or no injection, demonstrating small or no difference in pain outcomes. Studies investigating nerve blocks at the time of vaginal surgery have not evaluated the effect of infiltration of the space around the pudendal nerve.
View Article and Find Full Text PDFArthroscopy
December 2024
Texas Tech University Health Sciences Center, Department of Orthopaedic Surgery & Rehabilitation, Lubbock TX 79430. Electronic address:
Traditionally, distraction of the hip joint during hip arthroscopy has been achieved with the use of a perineal post which acts as a counterforce. However, our knowledge of the potential complications related to the use of a perineal post continues to grow. While pudendal neurapraxia is the most common of these potential complications, the perineal post may also cause skin tears of the perineum, erectile dysfunction and, in rare cases, permanent pudendal nerve injury.
View Article and Find Full Text PDFInt Urogynecol J
November 2024
Department of Obstetrics and Gynecology and Urology, New York Medical College, Valhalla, NY, USA.
Introduction And Hypothesis: Pudendal neuralgia is chronic pelvic pain associated with the pudendal nerve. Unfortunately, the best treatment approach is unknown. Our objective was to systematically assess interventions for pudendal neuralgia for improvement in pain.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!