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Surgery Plus Neuromodulation Offers Impressive Benefit for IC Patient With Complex Pain Condition

Armstrong GL, Vancaillie TG. Combined site-specific sacral neuromodulation and pudendal nerve release surgery in a patient with interstitial cystitis and persistent arousal. BMJ Case Rep. 2016 Jun 9;2016. pii: bcr2015213513. doi: 10.1136/bcr-2015-213513.
In this article, the authors describe a unique case report in which neuromodulation (electrical nerve stimulation) was used to treat a 35-year-old woman with a complicated pelvic nerve pain condition that resulted in urinary, sexual, and digestive dysfunction. She had a diagnosis of interstitial cystitis (IC), but also had pudendal neuralgia (a painful nerve inflammation) and persistent genital arousal disorder. The treatment for this patient included implantation of a device that offered combined sacral and pudendal nerve neuoromodulation, along with decompression surgery for the pudendal nerves at the same time. The authors say her clinical response was impressive. Although this article only represents the experience of a single patient, it is interesting because it suggests a novel combined surgical/neuromodulatory treatment approach could be helpful for some IC patients. Moreover, while neuromodulation for IC isn’t a new approach, the benefits of a combined sacral/pudendal nerve stimulator is fairly unique and has not been extensively explored in IC patients.