Sacral neuromodulation as a treatment for neuropathic clitoral pain after abdominal hysterectomy

Int Urogynecol J. 2010 Oct;21(10):1305-7. doi: 10.1007/s00192-010-1145-x. Epub 2010 Apr 13.

Abstract

Sacral neuromodulation (SNM) may be beneficial in the treatment of patients with chronic pelvic pain, although it is not an FDA-approved indication. We present a case of a 51-year-old patient that presented with symptoms of lower urinary tract dysfunction and clitoral pain after an abdominal hysterectomy. Electrophysiological evaluation suggested a pudendal nerve lesion. After failure of conservative treatment, she was offered SNM as a treatment for her voiding symptoms. During test stimulation, she experienced only moderate improvement in voiding symptoms, but a striking improvement in pain symptoms. She underwent a two-stage implantation of a neurostimulator with a successful outcome after 6 months' follow-up. The results of this report suggest that SNM may be effective in patients with neuropathic pelvic pain.

Publication types

  • Case Reports

MeSH terms

  • Abdomen
  • Clitoris / innervation*
  • Electric Stimulation Therapy*
  • Female
  • Humans
  • Hysterectomy / adverse effects*
  • Hysterectomy / methods
  • Lumbosacral Plexus
  • Middle Aged
  • Neuralgia / etiology*
  • Neuralgia / therapy*