International Urogynecology Journal

, Volume 21, Issue 5, pp 613–616 | Cite as

Pudendal nerve neuromodulation with neurophysiology guidance: a potential treatment option for refractory chronic pelvi-perineal pain

Case Report

Abstract

Refractory chronic pelvi-perineal pain (RCPPP) is a challenging entity that has devastating consequences for patient’s quality of life. Many etiologies have been proposed including pudendal neuralgia. Multiple treatment options are used but the reported results are sub-optimal and temporary. In this article, we present the technique of pudendal nerve neuromodulation with neurophysiology guidance as a treatment option for RCPPP. This technique is a two-step procedure that includes electrode implantation under neurophysiology guidance followed by the implantation of a permanent generator after a successful trial period. We report the cases of three women who underwent this procedure as a last-resort treatment option. After 2 years of follow-up, their symptoms are still significantly improved. No major complication occurred.

Keywords

Chronic pelvic pain Neurophysiology Neurostimulation Pudendal neuralgia Pudendal nerve 

Notes

Acknowledgements

We thank Tania Fayad, Ph.D., for critical reading of the article.

Conflict of interest

None.

References

  1. 1.
    Stav K, Dwyer PL, Roberts L (2009) Pudendal neuralgia. Fact of fiction? Obstet Gynecol Surv 64(3):190–199CrossRefPubMedGoogle Scholar
  2. 2.
    Labat JJ, Riant T, Robert R, Amarenco G, Lefaucheur JP, Rigaud J (2008) Diagnostic criteria for pudendal neuralgia by pudendal nerve entrapment (Nantes criteria). Neurourol Urodyn 27:306–310CrossRefPubMedGoogle Scholar
  3. 3.
    Hough DM, Wittenberg KH, Pawlina W, Maus TP, King BF, Vrtiska TJ et al (2003) Chronic perineal pain caused by pudendal nerve entrapment: anatomy and CT-guided perineural injection technique. AJR 181:561–567PubMedGoogle Scholar
  4. 4.
    Spinelli M, Malaguti S, Giasdiello G, Lazzeri M, Tarantola J, Hombergh UVD (2005) A new minimally invasive procedure for pudendal nerve stimulation to treat neurogenic bladder: description of the method and preliminary data. Neurourol Urodyn 24:305–309CrossRefPubMedGoogle Scholar
  5. 5.
    Peters KM, Feber KM, Bennett RC (2005) Sacral versus pudendal nerve stimulation for voiding dysfunction: a prospective, single-blinded, randomized, crossover trial. Neurourol Urodyn 24:643–647CrossRefPubMedGoogle Scholar

Copyright information

© The International Urogynecological Association 2009

Authors and Affiliations

  1. 1.Department of UrologyCentre Hospitalier Universitaire de SherbrookeSherbrookeCanada
  2. 2.Department of NeurologyCentre Hospitalier Universitaire de SherbrookeSherbrookeCanada

Personalised recommendations