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NEUROMODULATION IN PELVIC PAIN PREDOMINANT NEUROPATHICORIGINтезисы доклада
- Авторы: Isagulyan Emil D., Polushkin Andrey A., Tomskiy Alexey A., Lysachev Dmitry A., Pushkar Dmitry Yu
- Сборник: 15th EUGA Annual Congress 20-22 October 2022, Antibes – Palais des Congrès
- Тезисы
- Год издания: 2022
- Место издания: Antibes, France
- Первая страница: 193
- Последняя страница: 193
- Номер статьи: 109
- Аннотация: Emil D. Isagulyan (1) - Andrey A. Polushkin (1) - Alexey A. Tomskiy (1) - Dmitry A. Lysachev (1) - Dmitry Yu. Pushkar (2) N. N. Burdenko National Medical Research Center of Neurosurgery, Functional Neurosurgery, Moscow, Russian Federation (1) - A.I. Evdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia, Department of Urology, Moscow, Russian Federation (2) INTRODUCTION Among pain syndromes, approximately 25% of the patients have refractory pelvic pain syndromes, which consider one of the most difficult diseases to be diagnosed and cured. The methods of neuromodulation can be used in refractory pain, but a frequency of occurrence of these methods is very low. We would like to share our experience of using different neuromodulation methods in patients with refractory pelvic pain. PATIENTS AND METHODS In our case series were included 36 patients with refractory pelvic pain. In 16 patients were implanted sacral lead on one side of the sacral root, in 7 patients were implanted sacral lead on both side of the sacral root, in 5 patients were implanted spinal cord stimulation lead, in 3 patients were implanted spinal cord stimulation lead and sacral lead and in 5 patients were implanted sacral and pudendal nerve leads. We evaluate pain intensively with visual analog scale (VAS) and Brief Pain Inventory before test period, after the test period, after implantation of the pulse generator and in follow-up. All patients in our case series had a high point of the standard scale of the neuropathic pain: Pain Detect, DN4 and Leeds Assessment of Neuropathic Symptoms and Signs (LANSS). RESULTS Test stimulation was successful in 28 patients. Of the 28 patients with the implant 26 had a decrease in the severity of the worst pain compared to baseline. Median VAS before the operation was 9 points and 3,5 points in follow-up (p<0,005). Average mean of physical activity scale before the operation was 14.03 points and 3,125 points in a follow-up (p <0,05). In our case series not found a significant difference between pain duration and efficacy of neuromodulation therapy, but at the same time, we noted a clear correlation with catastrophizing and passive and coping strategies. The more pronounced they were, the worse the results were. Moreover, all cases of explantation were observed only in patients with an extremely pronounced degree of catstarophization and the absence of active strategies. Neuromodulation therapy therefore is an effective and safe method to manage pelvic pain.
- Добавил в систему: Лысачев Дмитрий Анатольевич