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Pulsed Radiofrequency May Provide Relief When Other IC Treatments Fail

Kim JH, Kim E, Kim BI. Pulsed radiofrequency treatment of the superior hypogastric plexus in an interstitial cystitis patient with chronic pain and symptoms refractory to oral and intravesical medications and bladder hydrodistension: A case report. Medicine (Baltimore). 2016 Dec;95(49):e5549.

This case report concerns a 35-year-old woman with interstitial cystitis (IC) who received a non-invasive treatment known as pulsed radiofrequency (PRF), in which a needle is used to deliver short bursts of energy to nerve tissue. In particular, the treatment was applied to the patient’s superior hypogastric plexus, a network of nerves in the abdomen. Over the preceding 7 years, the patient experienced pain in the lower abdomen due to bladder filling, pain near the vulva during sleep or changing posture, and other symptoms including urinary urgency and frequency, and nocturia. She had tried a variety of standard treatments, and none were very effective against pain and symptoms; these included bladder hydrodistension, sodium chondroitin sulfate given intravesically, and oral medications such as pentosan polysulfate and gabapentin. Given this situation, the authors decided they would try blocking the superior hypogastric plexus using anesthetic, which successfully but temporarily improved the patient’s pain. Because of these encouraging results, the patient underwent a session of PRF treatment of the superior hypogastric plexus, plus a second session 6 months later. The treatment seemed to be successful, and relieved pain and symptoms for at least 2 years and 6 months, according to this case report. Based on this experience, the authors say that PRF treatment could provide long-term improvements in pain and symptoms for other IC patients who aren’t achieving relief with standard treatments. However, it’s important to note that this treatment remains experimental, and would need to be more carefully studie to confirm it’s both safe and effective in this setting.