scholarly journals Percutaneous Tibial Nerve Stimulation in Chronic Post-Surgical Anorectal Pain: A Case Report

2021 ◽  
pp. 1-6
Author(s):  
Marta Pacheco ◽  
João Xavier ◽  
Olga Santos ◽  
Carina Raposo ◽  
Ana Margarida Regalado
Keyword(s):  
Nerve Stimulation ◽  
Negative Impact ◽  
Tibial Nerve ◽  
Pain Syndrome ◽  
Brief Pain Inventory ◽  
Lower Urinary Tract Dysfunction ◽  
Percutaneous Tibial Nerve Stimulation ◽  
Tibial Nerve Stimulation ◽  
Anorectal Pain ◽  
Patient Reported

<b><i>Introduction:</i></b> Anorectal pain is a symptom with a negative impact on quality of life and it can sometimes develop into a chronic pain syndrome. Structural anorectal pain is treated according to the underlying pathology. In situations of chronic post-surgical pain that is refractory to conventional therapeutic approaches, percutaneous tibial nerve stimulation (PTNS) is an option. PTNS is a neurostimulation technique used in the treatment of lower urinary tract dysfunction. There has been increasing evidence of its benefits for improving other conditions, such as chronic pelvic pain (CPP) and faecal incontinence (FI). <b><i>Case Presentation:</i></b> We report a case of a 45-year-old woman with chronic post-surgical anorectal pain (CPAP) treated with PTNS. The patient reported a consistent and dramatic decrease in both the frequency and intensity of pain, assessed by the Brief Pain Inventory (BPI). A decrease in the pain interference with mood, normal work, and walking/mobility was also noted, as evaluated by BPI and EQ-5D-3L questionnaires. <b><i>Discussion:</i></b> Neuromodulation treatments have been reported as effective for anorectal pain, but reports on the use of PTNS are rare. The tibial nerve is easily accessible and provides an optimal site for neurostimulation without the need of an operating room or anaesthesia. The overall improvement observed in this case of chronic anorectal pain suggests a potential new area of research for PTNS.

Long-Term Efficacy of Percutaneous Tibial Nerve Stimulation for Different Types of Lower Urinary Tract Dysfunction in Children

2009 ◽  
Vol 182 (4S) ◽  
pp. 2056-2061 ◽  
Author(s):  
Maria Luisa Capitanucci ◽  
Daniela Camanni ◽  
Francesca Demelas ◽  
Giovanni Mosiello ◽  
Antonio Zaccara ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Nerve Stimulation ◽  
Lower Urinary Tract ◽  
Tibial Nerve ◽  
Lower Urinary Tract Dysfunction ◽  
Percutaneous Tibial Nerve Stimulation ◽  
Tibial Nerve Stimulation ◽  
Different Types ◽  
Lower Urinary

scholarly journals Percutaneous Tibial Nerve Stimulation (PTNS ) in Iatrogenic Chronic Vulvar Pain

2017 ◽  
pp. 43-50
Author(s):  
Pedro Carvaljo Moreira
Keyword(s):  
Key Words ◽  
Pelvic Pain ◽  
Nerve Stimulation ◽  
Tibial Nerve ◽  
Treatment Options ◽  
Treatment Protocol ◽  
Percutaneous Tibial Nerve Stimulation ◽  
Vulvar Pain ◽  
Tibial Nerve Stimulation ◽  
Patient Reported

Chronic vulvar pain (CVP), although being fairly prevalent, in most cases is not attributable to a specified disorder, i.e., presents as vulvodynia. There are, however, many disorders known to cause CVP, such as radiotherapy and surgery. There have been, so far, no reports in the literature of effective treatment options for Iatrogenic CVP. Percutaneous tibial nerve stimulation (PTNS) is a neurostimulation technique used in the treatment of urinary urgency, frequency, urge incontinence, and urinary retention. There has been increasing evidence of its benefits in improving other conditions, such as chronic pelvic pain or sexual dysfunction. We report a case of a 62 year-old woman with iatrogenic chronic vulvar pain (CVP) submitted to PTNS. The patient reported a consistent and dramatic decrease in both frequency and intensity of pain, assessed by the Brief Pain Inventory (BPI). A decrease in the pain interference with mood, normal work, and walking/mobility was also noted, as evaluated by BPI and EQ-5D questionnaires. Even though a relapse of symptoms was seen after the end of the treatment protocol, it was possible to achieve more permanent benefits after a maintenance scheme of PTNS, with the patient becoming almost asymptomatic. Neuromodulation treatments have been reported as effective in cases of vulvodynia, however reports using PTNS are rare. The tibial nerve is easily accessible and provides an optimal site for neurostimulation without the need of an operating room or anesthesia. The overall improvement registered in this case of CVP elicits a new area of research for PTNS. {Need key words.} Key words: Chronic pain, pelvic pain, vulvar diseases, neuromodulation, percutaneous electric nerve stimulation, tibial nerve

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