International Urogynecology Journal

, Volume 21, Issue 12, pp 1553–1558 | Cite as

Sacral neuromodulation stimulation for IC/PBS, chronic pelvic pain, and sexual dysfunction

Review Article

Abstract

This study aims to review the use of sacral neuromodulation in the patient population with painful bladder syndrome/interstitial cystitis (PBS/IC), chronic pelvic pain (CPP), and sexual dysfunction. A literature review of the current research was carried out. This article highlights the current research findings and uses of sacral neuromodulation in patients with PBS/IC, CPP, vulvar vestibulitis, and erectile dysfunction. Current research on sacral neuromodulation on the abovementioned patient population has shown potential efficacy in pilot studies, though larger, multi-centered trials with long-term follow-up are needed.

Keywords

Chronic pelvic pain Interstitial cystitis Painful bladder syndrome Sacral neuromodulation Sexual dysfunction 

Notes

Conflicts of interest

None.

References

  1. 1.
    Symons S, Barnecott J, Harrison S (2005) Sacral nerve stimulation (neuromodulation) for the treatment of lower urinary tract symptoms in adult patients. ACRN 5(1):35–37Google Scholar
  2. 2.
    Bosch JLHR, Groen J (1998) Neuromodulation: urodynamic effects of sacral (S3) spinal nerve stimulation in patients with detrusor instability of detrusor hyperflexia. Behav Brain Res 92:141–150CrossRefPubMedGoogle Scholar
  3. 3.
    Comiter CV (2003) Sacral neuromodulation for the symptomatic treatment of refractory interstitial cystitis: a prospective study. J Urol 169(4):1369–1373CrossRefPubMedGoogle Scholar
  4. 4.
    Moldwin RM, Evans RJ, Stanford EJ, Rosenberg MT (2007) Rational approaches to the treatment of patients with interstitial cystitis. Urology 69(Suppl 4A):73–81CrossRefPubMedGoogle Scholar
  5. 5.
    Abrams P et al (2002) Report from the standardization sub-committee of the International Continence Society. Am J Obstet Gynecol 187(1):116–126CrossRefPubMedGoogle Scholar
  6. 6.
    van de Merwe JP, Nordling J, Bouchelouche P, Bouchelouche K, Cervigni M, Daha LK, Elneil S, Fall M, Hohlbrugger G, Irwin P, Mortensen S, van Ophoven A, Osborne JL, Peeker R, Richter B, Riedl C, Sairanen J, Tinzl M, Wyndaele JJ (2008) Diagnostic criteria, classification, and nomenclature for painful bladder syndrome/interstitial cystitis: an ESSIC proposal. Eur Urol 53:60–67CrossRefPubMedGoogle Scholar
  7. 7.
    Berry S, Bogart L, Soto M, et al (2009). Presented at the American Urological Association Annual Meeting April 25–29, Chicago.Google Scholar
  8. 8.
    Laird J (1999) Visceral pain: where do we go from here? Euro J Pain 3(2):75–76CrossRefGoogle Scholar
  9. 9.
    Kream RM, Carr DB (1999) Interstitial cystitis: a complex visceral pain syndrome. J Pain 8(3):139Google Scholar
  10. 10.
    Myers DL, Aguilar VC (2002) Gynecologic transformations of interstitial cystitis. Clin Obstet Gynecol 45(1):233–241CrossRefPubMedGoogle Scholar
  11. 11.
    Moore KL (1998) The developing human: clinically oriented embryology, 4th edn. Saunders, PhiladelphiaGoogle Scholar
  12. 12.
    Evans RJ (2002) Treatment approaches for interstitial cystitis: multimodal therapy. Rev Urol 4(1suppl):S16–S20PubMedGoogle Scholar
  13. 13.
    Forrest JB, Nickel JC, Moldwin RM (2007) Chronic prostatitis/chronic pelvic pain and male interstitial cystitis: enigmas and opportunities. Urology 69(suppl 4A):60–63CrossRefPubMedGoogle Scholar
  14. 14.
    Clemens JQ, Meenan RT, Rosetti MC, Gao SY, Calhoun EA (2005) Prevalence and incidence of interstitial cystitis in a managed care population. J Urol 173(1):98–102CrossRefPubMedGoogle Scholar
  15. 15.
    Whitmore K, Siegel JF, Kellogg-Spadt S (2007) Interstitial cystitis/painful bladder syndrome as a cause of sexual pain in women: a diagnosis to consider. J Sex Med 4:720–727CrossRefPubMedGoogle Scholar
  16. 16.
    Parsons CL (2007) The role of the urinary epithelium in the pathogenesis of interstitial cystitis/prostatitis/urethritis. Urology 69(suppl4A):9–16CrossRefPubMedGoogle Scholar
  17. 17.
    Sant GR, Kempuraj D, Marchand JE, Theoharides TC (2007) The mast cell in interstitial cystitis: role in pathophysiology and pathogenesis. Urology 69(suppl4A):34–40CrossRefPubMedGoogle Scholar
  18. 18.
    Nazif O, Teichman J, Gebhart GF (2007) Neural upregulation in interstitial cystitis. Urology 69(suppl4A):24–33CrossRefPubMedGoogle Scholar
  19. 19.
    Wesselmann U (2001) Neurogenic inflammation and chronic pelvic pain. World J Urol 19:180–185CrossRefPubMedGoogle Scholar
  20. 20.
    Kream RM Carr DB (1999) Interstitial cystitis. Pain Forum 8:143–150Google Scholar
  21. 21.
    Rosenberg MT, Page S, Hazzard MA (2007) Prevalence of interstitial cystitis in a primary care setting. Urology 69(suppl4A):48–52CrossRefPubMedGoogle Scholar
  22. 22.
    Peters KM, Carey JM, Konstandt DB (2003) Sacral neuromodulation for the treatment of interstitial cystitis: outcomes based on technique. Int Urogynecol J 14:223–228CrossRefGoogle Scholar
  23. 23.
    Everaert K, Devulder J, De Muynck M et al (2001) The pain cycle: implications for the diagnosis and treatment of pelvic pain syndromes. Int Urogynecol J 12:9–14CrossRefGoogle Scholar
  24. 24.
    Siegel S, Paszkiewicz E, Kirkpatrick C, Hinkel B, Oleson K (2001) Sacral nerve stimulation in patients with intractable pelvic pain. J Urol 166:1742–1745CrossRefPubMedGoogle Scholar
  25. 25.
    Maher CF, Carey MP, Dwyer PL, Schluter PL (2001) Percutaneous sacral nerve root neuromodulation for intractable interstitial cystitis. J Urol 165:884–886CrossRefPubMedGoogle Scholar
  26. 26.
    Whitmore K, Payne C et al (2003) Sacral neuromodulation in patients with interstitial cystitis: a multicenter clinical trial. Int Urogynecol J Pelvic Floor Dysfunct 14:305–309CrossRefPubMedGoogle Scholar
  27. 27.
    Peters KM, Konstandt D (2004) Sacral neuromodulation decreases narcotic requirements in refractory interstitial cystitis. BJU Int 93:777–779CrossRefPubMedGoogle Scholar
  28. 28.
    Chai TC, Zhang C, Warren JW, Keay S (2000) Percutaneous sacral third nerve root neurostimulation improves symptoms and normalizes urinary HB-EGF levels and antiproliferative activity in patients with interstitial cysitits. Urology 55:643CrossRefPubMedGoogle Scholar
  29. 29.
    Siegel SW, Catanzaro F, Dijkema HE, Elhilali MM, Fowler CJ, Gajewski JB et al (2000) Long-term results of a multicenter study on sacral nerve stimulation for treatment of urinary urge incontinence, urgency-frequency, and retention. Urology 4:87–91CrossRefGoogle Scholar
  30. 30.
    Rockley R, Vasavada S, Daneshagani F, Murphy D, Hijaz A, Vaze A (2005). Neuromodulation for interstitial cystitis. Clev Clin Glickman Urol Inst. http://my.clevelandclinic.org/Documents/Urology/AUA%20Abstracts%202005.pdf
  31. 31.
    Schmidt RA, Zermann DH, Doggweiler R (1999) Urinary incontinence update: old traditions and new concepts. Adv Intern Med 44:19–57PubMedGoogle Scholar
  32. 32.
    Brookoff DM, Bennett DS (2006) Neuromodulation in intractable interstitial cystitis and related pelvic pain syndromes. Pain Med 7(S1):S166–S184CrossRefGoogle Scholar
  33. 33.
    Peters KM, Carrico DJ, Kalinowski SE, Ibrahim IA, Diokno AC (2007) Prevalence of pelvic floor dysfunction in patients with interstitial cystitis. Urology 70:16–18CrossRefPubMedGoogle Scholar
  34. 34.
    Finamore PS, Goldstein HB, Whitmore KE (2008) Pelvic floor muscle dysfunction: a review. J Pelvic Med Surg 14(6):417–422CrossRefGoogle Scholar
  35. 35.
    Weiss JM (2001) Pelvic floor myofascial trigger points: manual therapy for interstitial cystitis and the urgency-frequency syndrome. J Urol 166:2226–2231CrossRefPubMedGoogle Scholar
  36. 36.
    Hellstrom WJ, Schmidt RA, Lue TF, Tanagho EA (1987) Neuromuscular dysfunction in non-bacterial prostatitis. Urology 30:183–188CrossRefPubMedGoogle Scholar
  37. 37.
    Jarrett ME (2005) Neuromodulation for constipation and fecal incontinence. Urol Clin North Am 32:79–87CrossRefPubMedGoogle Scholar
  38. 38.
    American Psychiatric Association (1994) Diagnostic and statistical manual of mental disorders, fourth edition. American Psychiatric Association, Washington, pp 493–522Google Scholar
  39. 39.
    Frank E, Anderson C, Rubinstein D (1978) Frequency of sexual dysfunction in “normal” couples. N Engl J Med 299:111–115CrossRefPubMedGoogle Scholar
  40. 40.
    Rosen RC, Taylor JF, Leiblum SR, Bachmann GA (1993) Prevalence of sexual dysfunction in women: results of a survey study of 329 women in an outpatient gynecological clinic. J Sex Marital Ther 19:171–188PubMedGoogle Scholar
  41. 41.
    Spector IP, Carey MP (1990) Incidence and prevalence of the sexual dysfunctions: a critical review of the empirical literature. Arch Sex Behav 19:389–408CrossRefPubMedGoogle Scholar
  42. 42.
    Laumann EO, Palik A, Rosen RC (1999) Sexual dysfunction in the United States. JAMA 281:537–544CrossRefPubMedGoogle Scholar
  43. 43.
    Pauls RN, Marinkovic SP, Silva WA, Rooney CM, Kleeman SD, Karram MM (2007) Effects of sacral neuromodulation on female sexual function. Int Urogynecol J 18:391–395CrossRefGoogle Scholar
  44. 44.
    McKenna KE (2002) The neurophysiology of female sexual function. World J Urol 20(2):93–100CrossRefPubMedGoogle Scholar
  45. 45.
    O’Connell HE, Sanjeevan KV, Huston JM (2005) Anatomy of the clitoris. J Urol 174(4, Pt1):1189–1195CrossRefPubMedGoogle Scholar
  46. 46.
    Pauls RN, Marinkovic SP, Silva WA et al (2007) Effects of sacral neuromodulation on female sexual function. Int Urogynecol J 18:391–395CrossRefGoogle Scholar
  47. 47.
    Peters KM, Ingber M, Killinger K, Ibrahim IA (2008) The effect of neuromodulation on female sexual function. Neurourol Urodyn 27:114–115CrossRefGoogle Scholar
  48. 48.
    Lombardi G, Mondaini N, Macchiarella A, Cilotti A, Del Popolo G (2008) Clinical female sexual outcome after sacral neuromodulation implant for lower urinary tract symptom (LUTS). J Sex Med 5(6):1411–1417CrossRefPubMedGoogle Scholar
  49. 49.
    Ramsey LB, Wright J, Fischer JR (2009) Sacral neuromodulation in the treatment of vulvar vestibulitis syndrome. Obstet Gynecol 114:487–489CrossRefGoogle Scholar
  50. 50.
    Bernstein AJ, Peters KM (2005) Expanding indications for neuromodulation. Urol Clin N Am 32:59–63CrossRefGoogle Scholar
  51. 51.
    Shafik A (1996) Extrapelvic cavernous nerve stimulation in erectile dysfunction. Andrologia 28:151–156CrossRefPubMedGoogle Scholar
  52. 52.
    Lombardi G, Mondaini N, Giubilei G, Macchiarella A, Lecconi F, Del Popolo G (2008) Sacral neuromodulation for lower urinary tract dysfunction and impact on erectile function. J Sex Med 5(9):2135–2140CrossRefPubMedGoogle Scholar

Copyright information

© The International Urogynecological Association 2010

Authors and Affiliations

  1. 1.The Pelvic and Sexual Health InstitutePhiladelphiaUSA

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