Presented at the 2012 AAPM Annual Meeting « Back

Treatment of Chronic Pelvic and Abdominal Pain with Peripheral Nerve Field Stimulation

Alexander E. Yakovlev, MD, aeyakovlev@yahoo.com¹, Beth E. Resch, APNP¹, (1) Comprehensive Pain Management of the Fox Valley SC, Appleton, Wisconsin

Background and Aims: The etiology of chronic pelvic and abdominal pain is complex and can be difficult to control because of the different approach in diagnosis and treatment by a variety of physicians involved in patient care. We report successful treatment of chronic pelvic and abdominal pain developed after multiple abdominal surgeries with peripheral nerve field stimulation (PNFS). Methods: A 39-year-old female presented with a 10-year history of chronic pelvic and lower abdominal pain developed after tubal ligation. Conservative medication management, trigger point injections, ganglion impar block, superior hypogastric plexus block, and epidural injections gave the patient no relief. She underwent successful PNFS trial with two 8-electrode leads (Medtronic Inc., Minneapolis, MN) subcutaneously placed over suprapubic area. During PNFS trial, the patient reported greater than 50% improvement in pain, and 2 weeks later underwent placement of permanent leads and RestoreULTRA rechargeable generator. Results: After final implantation, the patient reported significant pain relief (>50% reduction in VAS) at 12 months and used PNFS 24 hours per day. Patient discontinued use of opioid and non-opioid pain medications. She was able to resume educational pursuits and reported improved social relationships. Conclusion: PNFS is a treatment option for chronic pelvic and abdominal pain in patients who have exhausted conservative therapies and more conventional interventional pain techniques. PNFS can result in adequate pain control and lead to functional recovery.

Funding: None