Sacral nerve stimulation in patients with chronic intractable pelvic pain

Purpose: Transforamenal sacral nerve stimulation with an implantable neurop rosthetic device has been shown to benefit patients with chronic voiding dy sfunction. In this study we measured the effectiveness of sacral nerve stim ulation in 10 patients with chronic intractable pelvic pain. Materials and Methods: After successful percutaneous trial stimulation, a n europrosthetic sacral nerve stimulation device was surgically implanted in 10 patients with chronic intractable pelvic pain. Leads were placed in the S3 and S4 foramen in 8 and 2 cases, respectively. Patients were evaluated t hroughout the study using a patient pain assessment questionnaire on a scal e of 0 -absent to 5- excruciating pain. Pain was assessed at baseline, duri ng test stimulation, and 1, 3 and 6 months after surgical lead implantation . An additional long-term assessment was done at a median followup of 19 mo nths. Results: Of the 10 patients with the implant 9 had a decrease in the severi ty of the worst pain compared to baseline at a median followup of 19 months . The number of hours of pain decreased from 13.1 to 6.9 at the same follow up interval. There was also an average decrease in the rate of pain from 9. 7 at baseline to 4.4 on a scale of 10 -always to 0 -never having pain. At a median of 19 months 6 of 10 patients reported significant improvement in p elvic pain symptomology. Conclusions: These data imply that transforamenal sacral nerve stimulation can have beneficial effects on the severity and frequency of chronic intrac table pelvic pain. Future clinical studies are necessary to determine the l ong-term effectiveness of this therapy.