The site of the Media Sphera Publishers contains materials intended solely for healthcare professionals.
By closing this message, you confirm that you are a certified medical professional or a student of a medical educational institution.

Login
EN
+7 (495) 482-4118
+7 (495) 482-4329
+8 800 250-18-12
  • (toll-free number for subscriptions)
    Mon-Fri from 10 a.m. to 6 p.m.

  • © 1998-2025
+7 (495) 482-43-29
EN
All journals
Journal
Year
Year
Search result: 0

Polushkin A.A.

Burdenko Neurosurgical Institute, Moscow, Russia

Isagulyan E.D.

Burdenko Neurosurgical Institute, Moscow, Russia

Tomskiĭ A.A.

FGBU "NII neĭrokhirurgii im. N.N. Burdenko" RAMN, Moskva

Dorokhov E.V.

Sechenov First Moscow State Medical University, Moscow, Russia

Salyukov R.V.

Burdenko Neurosurgical Institute, 4-ya Tverskaya-Yamskaya Str., 16, Moscow, Russia, 125047

The use of surgical neuromodulation to treat chronic pelvic pain

Authors:

Polushkin A.A., Isagulyan E.D., Tomskiĭ A.A., Dorokhov E.V., Salyukov R.V.

More about the authors

Journal: Burdenko's Journal of Neurosurgery. 2019;83(2): 49‑58

DOI: 10.17116/neiro20198302149

Read: 6559 times

Download PDF (RU)
Download PDF
Contact the author
Table of contents

THE USE OF SURGICAL NEUROMODULATION TO TREAT CHRONIC PELVIC PAIN
THE USE OF SURGICAL NEUROMODULATION TO TREAT CHRONIC PELVIC PAIN

To cite this article:

Polushkin AA, Isagulyan ED, Tomskiĭ AA, Dorokhov EV, Salyukov RV. The use of surgical neuromodulation to treat chronic pelvic pain. Burdenko's Journal of Neurosurgery. 2019;83(2):49‑58. (In Russ., In Engl.)
https://doi.org/10.17116/neiro20198302149

Подписка 2025 Журнал «Вопросы нейрохирургии» имени Н.Н. Бурденко (Burdenko's Journal of Neurosurgery)
МСФ на ЯМ
Использование инфографики авторами научных работ
Close metadata
Recommended articles:
Current state of algo­logy — pain medi­cine — in the Russian Fede­ration. Burdenko's Journal of Neurosurgery. 2024;(6):5-12
Dysfunctional pelvic pain in women. Russian Journal of Pain. 2025;(2):32-37
Gut—brain: inte­ractions in health and pathology. Russian Journal of Preventive Medi­cine. 2025;(11):106-112
Abstract:

Chronic pelvic pain (CPP) is a pain syndrome that is very difficult to treat. The effectiveness of CPP treatment remains low despite the use of integrated approaches. That is why it is necessary to search for new treatment approaches and methods. Surgical neuromodulation has recently been used increasingly often to treat CPP. Objective — to evaluate the effectiveness of different types of neurostimulation in patients with chronic pelvic pain. Material and methods. Thirty-two patients were treated at the N.N. Burdenko National Scientific and Practical Center for Neurosurgery. All the patients were diagnosed with CPP and transferred to the Center because of unsatisfactory results of earlier treatment. The mean duration of pain was 8.6 years (range: 1—31 years). Pain intensity and the neuropathic component of the pain syndrome were assessed using the conventional scales and questionnaires (VAS, LANSS, Pain Detect, and DN4). The levels of anxiety, depression, and catastrophic pain were also assessed. The effect of pain on quality of life was evaluated using the modified Brief Pain Inventory (BPI). All the selected patients underwent trial lead implantation at the first stage. Sacral root stimulation was used in 15 patients (unilateral one in 8 patients and bilateral one in 7 patients); three patients underwent spinal cord stimulation; 14 patients were treated with combined neurostimulation. Results. In 27 (84.37%) patients, the trial period was regarded as positive and the systems were implanted for chronic neurostimulation. After one year of stimulation, the mean VAS score for pain intensity was 3.53 (compared to 8.61 before the surgery). Regarding quality of life, the most significant effects of treatment were as follows: the number of pain paroxysms was reduced; physical self-maintenance, social life, sleep, and sexual activity were improved; and daily physical activity was increased. Conclusions. Neurostimulation ensures a stable pain relief and improves quality of life in patients with chronic pelvic pain refractory to conservative treatment.

Keywords:

chronic pelvic pain
neuromodulation
sacral neurostimulation
pudendal neurostimulation

Authors:

Polushkin A.A.

Burdenko Neurosurgical Institute, Moscow, Russia

Isagulyan E.D.

Burdenko Neurosurgical Institute, Moscow, Russia

Tomskiĭ A.A.

FGBU "NII neĭrokhirurgii im. N.N. Burdenko" RAMN, Moskva

Dorokhov E.V.

Sechenov First Moscow State Medical University, Moscow, Russia

Salyukov R.V.

Burdenko Neurosurgical Institute, 4-ya Tverskaya-Yamskaya Str., 16, Moscow, Russia, 125047

Close metadata

References:

  1. Zaytsev AV, Sharov MN, Pushkar’ DYu, Khodyreva LA, Dudareva AA. Khronicheskaya tazovaya bol’. M: ABV-press, 2016;8-13 (In Russ.)
  2. Engeler D, Baranowski AP, Borovicka J, Cottrell A, Dinis-Oliveira P, Elneil S, Hughes J, Messelink EJ, van Ophoven A, Reisman Y, Williams C. Guidelines on chronic pelvic pain. Eur Urol. 2013;64(3). https://doi.org/10.1016/j.eururo.2013.04.035
  3. Merskey H, Bogduk N, ed. Classification of chronic pain. Description of chronic pain syndromes and definitions of pain terms. 2nd ed. Seattle: IASP Press, 1994;209-213. https://doi.org/10.1097/00002508-199506000-00024
  4. Mezhdunarodnoe obshchestvo po izucheniyu boli [arkhiv]. (Ssylka aktivna na 01.01.2019.) http://www.iasp-pain.org/Education/
  5. Yosef Ali, Ghaffar Ahmed Abdel, Al-Hussaini Tarek, Abdellah Mohamad, Cua Georgine, Bedaiwy A. Chronic pelvic pain: Pathogenesis and validated assessment. Middle East Fertility Society Journal. 2016 December;21(Issue 4): 205-221. https://doi.org/10.1016/j.mefs.2016.08.001
  6. Abbott J, Hawe J, Hunter D, Holmes M, Finn P, Garry R. Laparoscopic excision of endometriosis: a randomized, placebo-controlled trial. Fertil Steril. 2004;82:878-884. https://doi.org/10.1016/j.fertnstert.2004.03.046
  7. Diatchenko L, Nackley AG, Tchivileva IE, Shabalina SA, Maixner W. Genetic architecture of human pain perception. Trends Genet. 2007;23:605-613. https://doi.org/10.1016/j.tig.2007.09.004
  8. McKernan LC, Walsh CG, Reynolds WS, Crofford LJ, Dmochowski RR, Williams DA. Psychosocial co-morbidities in Interstitial Cystitis/Bladder Pain syndrome (IC/BPS): A systematic review. Neurourol Urodyn. 2017 Oct 9. https://doi.org/10.1002/nau.23421
  9. Chhabria A. Psychogenic Pain Disorder — Differential Diagnosis and Treatment. Supplement to Journal of the association of physicians of India, 2015 Feb;63(2 Suppl):36-40. https://doi.org/10.5005/jp/books/12703_7
  10. Doggweiler R, Whitmore KE, Meijlink JM, Drake MJ, Frawley H, Nordling J, Hanno P, Fraser MO, Homma Y, Garrido G, Gomes MJ, Elneil S, van de Merwe JP, Lin ATL, Tomoe H. A standard for terminology in chronic pelvic pain syndromes: A report from the chronic pelvic pain working group of the international continence society. Neurourol Urodyn. 2017 Apr;36(4):984-1008. https://doi.org/10.1002/nau.23072
  11. Engeler D, Baranowski AP, Borovicka J, Cottrell A, Dinis-Oliveira P, Elneil S, Hughes J, Messelink EJ, van Ophoven A, Reisman Y, Williams C. Guidelines on chronic pelvic pain. Eur Urol. 2013;64(3). https://doi.org/10.1016/j.eururo.2013.04.035
  12. Shoskes DA, Nickel JC. Classification and treatment of men with chronic prostatitis/chronic pelvic pain syndrome using the UPOINT system. World J Urol. 2013 Aug;31(4):755-760. https://doi.org/10.1007/s00345-013-1075-6
  13. Apostolidis A, Dasgupta P, Denys P, Elneil S, Fowler CJ, Giannantoni A, Karsenty G, Schulte-Baukloh H, Schurch B, Wyndaele JJ. European Consensus Panel. Recommendations on the use of botulinum toxin in the treatment of lower urinary tract disorders and pelvic floor dysfunctions: European consensus report. Eur Urol. 2009 Jan;55(1):100-119. https://doi.org/10.1016/j.eururo.2008.09.009
  14. Shoskes DA, Katz E. Multimodal therapy for chronic prostatitis/chronic pelvic pain syndrome. Curr Urol Rep. 2005;6:9-296. https://doi.org/10.1007/s11934-005-0027-0
  15. Jarrell JF, Vilos GA, Allaire C, Burgess S, Fortin C, Gerwin R, Lapensée L, Lea RH, Leyland NA, Martyn P, Shenassa H, Taenzer P, Abu-Rafea B. Chronic Pelvic Pain Working Group; SOGC. Consensus guidelines for the management of chronic pelvic pain. J Obstet Gynaecol Can. 2005 Aug;27(8):781-826. https://doi.org/10.1016/s1701-2163(16)30732-0
  16. Xuewen Jiang, Fuller TW, Bandari J, Bansal U, Zhaocun Zhang, Shen B, Jicheng Wang, Roppolo JR, de Groat WC, Changfeng Tai. Contribution of GABAA, Glycine, and Opioid Receptors to Sacral Neuromodulation of Bladder Overactivity in Cats. Journal of Pharmacology and Experimental Therapeutics. 2016 December;359(3)436-441. https://doi.org/10.1124/jpet.116.235846
  17. Zhou Y, Wang Y, Abdelhady M, Mourad MS, Hassouna MM. Change of vanilloid receptor 1 following neuromodulation in rats with spinal cord injury. J Surg Res. 2002 Sep;107(1):4-140. https://doi.org/10.1006/jsre.2002.6481
  18. Peters KM, Jayabalan N, Bui D, Killinger K, Chancellor M, Tyagi P. Effect of Sacral Neuromodulation on Outcome Measures and Urine Chemokines in Interstitial Cystitis/Painful Bladder Syndrome Patients. Low Urin Tract Symptoms. 2015 May;7(2):77-83. https://doi.org/10.1111/luts.12054
  19. Dudding TC, Vaizey CJ. Bacterial colonization of stimulation electrode wires in patients undergoing temporary sacral nerve stimulation. Colorectal Dis. 2010;12:43-141. https://doi.org/10.1111/j.1463-1318.2009.01896.x
  20. Donon L, Robert G, Ballanger P. Sacral neuromodulation: results of a monocentric study of 93 patients. Prog Urol. 2014 Dec;24(17):31-1120. https://doi.org/10.1016/j.purol.2014.09.037
  21. Martellucci J, Naldini G, Carriero A. Sacral nerve modulation in the treatment of chronic pelvic pain. Colorectal Disease. 2012 Jul;27(7):921-926. https://doi.org/10.1111/j.1463-1318.2011.02659.x
  22. Thompson JH, Sutherland SE, Siegel SW. Sacral neuromodulation: Therapy evolution. Indian. Urol. 2010;26:379-384. https://doi.org/10.4103/0970-1591.70576
  23. Hanno PM, Burks DA, Clemens JQ, Dmochowski RR, Erickson D, FitzGerald PM, Forrest JB, Gordon B, Gray M, Mayer RD, Moldwin R, Newman DK, Nyberg LJr, Payne CK, Wesselmann U, Faraday MM. Guideline on the Diagnosis and Treatment of Interstitial Cystitis/Bladder Pain Syndrome. American Urological Association Education and Research, Inc, 2014; with permission. Available at: http://www.auanet.org/education/guidelines/ic-bladder-pain-syndrome.cfm
  24. Schmidt RA, Jonas U, Oleson KA, Janknegt RA, Hassouna MM, Siegel SW, van Kerrebroeck PEW. Sacral nerve stimulation for treatment of refractory urinary urge incontinence. J Urol. 1999;162:352-335.7 https://doi.org/10.1016/s0022-5347(05)68558-8
  25. Liberman D, Ehlert MJ, Siegel SW. Sacral Neuromodulation in Urological Practice. Urology. 2017;99:14-22. https://doi.org/10.1016/j.urology.2016.06.004
  26. Engeler D (chair), Baranowski AP, Borovicka J, Cottrell A, Dinis-Oliveira P, Elneil S, Hughes J, Messelink EJ, van Ophoven A, Reisman Y, de Williams AC. Guidelines on Chronic Pelvic Pain. European Association of Urology. 2014.
  27. Chartier-Kastler E, Ballanger P, Belas M, Biserte J, Corbel L, Gamé X, Grise P, Karsenty G, Le Normand L, Mauroy B, Pasquale J, Ruffion A, Rousseau T, Saussine C, Suberville M, Tollon C. Club de neuromodulation del‘Association française d‘urologie. Sacral neuromodulation with InterStim system: Results from the French national register. Progres en Urologie. 2011 Mar;21(3):209-217. https://doi.org/10.1016/j.purol.2010.05.008
  28. Karasev S, Yakovlev A, Resch B. Sacral nerve stimulation for treatment of perineal pain. European Journal of Pain Supplements. 2011;5(1):288-289. https://doi.org/10.1016/s1754-3207(11)70994-4
  29. Peters KM. Pudendal Neuromodulation for Sexual Dysfunction. The Journal of Sexual Medicine. 2013;10(4):908-911. https://doi.org/10.1111/jsm.12138
  30. Peters KM, Killinger KA, Jaeger C, Chen C. Pilot Study Exploring Chronic Pudendal Neuromodulation as a Treatment Option for Pain Associated with Pudendal Neuralgia: Neuromodulation and Pudendal Neuralgia. LUTS: Lower Urinary Tract Symptoms. 2015;7(3):138-142. https://doi.org/10.1111/luts.12066
  31. Al Tamimi M, Davids HR, Barolat G, Krutsch J, Ford T. Subcutaneous Peripheral Nerve Stimulation Treatment for Chronic Pelvic Pain: peripheral stimulator for pelvic pain. Neuromodulation: Technology at the Neural Interface. 2008;11(4):277-281. https://doi.org/10.1111/j.1525-1403.2008.00176.x
  32. Heinze K, Hoermann R, Fritsch H, Dermietzel R, van Ophoven A. Comparative pilot study of implantation techniques for pudendal neuromodulation: technical and clinical outcome in first 20 patients with chronic pelvic pain. World Journal of Urology. 2015;33(2):289-294. https://doi.org/10.1007/s00345-014-1304-7
  33. Hope ER, Gruber DD. Coccygeal Fracture Pain Cured by Sacral Neuromodulation: A Case Report: Letter to the Editor. Neuromodulation: Technology at the Neural Interface. 2013;16(6):614-617. https://doi.org/10.1111/ner.12002
  34. Lavonius M, Suvitie P, Varpe P, Huhtinen H. Sacral Neuromodulation: Foray into Chronic Pelvic Pain in End Stage Endometriosis. Case Rep Neurol Med. 2017. https://doi.org/10.1155/2017/2197831
  35. Sokal P, Zieliński P, Harat M. Sacral roots stimulation in chronic pelvic pain. Neurol Neurochir Pol. 2015;49(5):307-312. https://doi.org/10.1016/j.pjnns.2015.07.003
  36. Peters KM, Feber KM, Bennett RC. A prospective, single-blind, randomized crossover trial of sacral vs pudendal nerve stimulation for interstitial cystitis. BJU Int. 2007 Oct;100(4):835-839. https://doi.org/10.1111/j.1464-410x.2007.07082.x
  37. Siegel S, Paszkiewich E, Kirkpatrick C, Hinkel B, Oleson K. Sacral nerve stimulation in patients with chronic intractable pelvic pain. The Journal of Urology. 2001 Nov;166(Issue 5):1742-1745. https://doi.org/10.1016/s0022-5347(05)65665-0
  38. Abdel-Aziz S, Ghaleb A. Combined Sacral Nerve Roots Stimulation and Low Thoracic Spinal Cord Stimulation for the Treatment of Chronic Pelvic Pain. Pain Studies and Treatment. 2014;2(2). Article ID:44848,5 pages. https://doi.org/10.4236/pst.2014.22014
  39. Zhou Y, Wang Y, Abdelhady M, Mourad MS, Hassouna MM. Change of vanilloid receptor 1 following neuromodulation in rats with spinal cord injury. J Surg Res. 2002 Sep;107(1):4-140. https://doi.org/10.1016/s0022-4804(02)96481-4
  40. Peters KM, Jayabalan N, Bui D, Killinger K, Chancellor M, Tyagi P. Effect of Sacral Neuromodulation on Outcome Measures and Urine Chemokines in Interstitial Cystitis/Painful Bladder Syndrome Patients. Low Urin Tract Symptoms. 2015 May;7(2):77-83. https://doi.org/10.1111/luts.12054
  41. Henderson JM, Schade CM, Sasaki J, David L. Caraway, John C. Oakley. Prevention of mechanical failures in implanted spinal cord stimulation systems. Neuromodulation. 2006;9:183-191. https://doi.org/10.1111/j.1525-1403.2006.00059.x
  42. Oakely JC, Prager JP. Spinal Cord Stimulation: mechanisms of action. Spine. 2002;27:2574-2583. https://doi.org/10.1055/b-0034-45944
  43. Isagulyan ED, Shabalov VA. Khirurgicheskoe lechenie neiropaticheskikh bolevykh sindromov. Neyrokhirurgiya. 2009;2:5-12. (In Russ.)
  44. Isagulyan ED, Shabalov VA. Metody neyrostimulyatsiy v lecheniy boli. Manage Pain. 2014;4:48-54. (In Russ.)
  45. Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta psychiatrica. 1983;67(6):361-370. https://doi.org/10.1037/t03589-000
  46. Matzel KE, Chartier-Kastler E, Knowles CH, Lehur PA, Muñoz-Duyos A, Ratto C, Rydningen MB, Sørensen M, van Kerrebroeck P, de Wachter S. Sacral Neuromodulation: Standardized Electrode Placement Technique: Neuromodulation: Technology at the Neural Interface. 2017;20(8):816-824. https://doi.org/10.1111/ner.12695
  47. Corey W Hunter, Brad Stovall, Grant Chen, Jonathan Carlson, and Robert Levy. Anatomy, Pathophysiology and Interventional Therapies for Chronic Pelvic Pain: A Review. Pain Physician. 2018;21:147-167. ISSN 1533-3159. https://doi.org/10.1007/978-3-319-60361-2_2
  48. Justina Tam, Charles Loeb, Daniel Grajower, Jason Kim, Steven Weissbart. Neuromodulation for Chronic Pelvic Pain. Current Urology Reports. 2018;19:32. https://doi.org/10.1007/s11934-018-0783-2
  49. Heinze K, Hoermann R, Fritsch H, Dermietzel R, van Ophoven A. Comparative pilot study of implantation techniques for pudendal neuromodulation: technical and clinical outcome in first 20 patients with chronic pelvic pain. World Journal of Urology. 2015.33(2):289-294. https://doi.org/10.1007/s00345-014-1304-7
  50. Abdi S, Shenouda P, Patel N, Saini B, Bharat Y, Calvillo O. A Novel Technique for Pudendal Nerve Block. 2004;7(3):4. https://doi.org/10.1016/s1090-3801(09)60868-5
  51. Rokyta R, Fricová J. Neurostimulation methods in the treatment of chronic pain. Physiol Res. 2012;61(Suppl 2):S23-S31. Review. PubMed PMID: 23130900. https://doi.org/10.5772/57449
  52. Hunter Corey, Dave Nimish´, Diwan Sudhir, Deer Timothy. Neuromodulation of Pelvis Visceral Pain: Review Literature and Case Series of Potential Novel Targets for Treatment. World Institute of Pain. 1530-7085/13 Pain Practice. 2013;13(Issue 1):3-17. https://doi.org/10.1111/j.1533-2500.2012.00558.x
  53. Kumar K, Toth C, Nath RK, Laing P. Epidural spinal cord stimulation for treatment of chronic pain — some predictors of success. A 15-year experience. Surg Neurol. 1998;50:110-121. https://doi.org/10.1016/s0090-3019(98)00012-3
  54. Lavonius M, Suvitie P, Varpe P, Huhtinen H. Sacral Neuromodulation: Foray into Chronic Pelvic Pain in End Stage Endometriosis. Case Rep Neurol Med. 2017. https://doi.org/10.1155/2017/2197831
  55. Sokal P, Zieliński P, Harat M. Sacral roots stimulation in chronic pelvic pain. Neurol Neurochir Pol. 2015;49(5):307-312. https://doi.org/10.1016/j.pjnns.2015.07.003
  56. Peters KM, Feber KM, Bennett RC. A prospective, single-blind, randomized crossover trial of sacral vs pudendal nerve stimulation for interstitial cystitis. BJU Int. 2007 Oct;100(4):835-839. https://doi.org/10.1111/j.1464-410x.2007.07082.x
  57. Siegel S, Paszkiewich E, Kirkpatrick C, Hinkel B, Oleson K. Sacral nerve stimulation in patients with chronic intractable pelvic pain. The Journal of Urology. 2001 Nov;166(Issue 5):1742-1745. https://doi.org/10.1016/s0022-5347(05)65665-0
  58. Abdel-Aziz S, Ghaleb A. Combined Sacral Nerve Roots Stimulation and Low Thoracic Spinal Cord Stimulation for the Treatment of Chronic Pelvic Pain. Pain Studies and Treatment. 2014;2(2). Article ID:44848,5 pages. https://doi.org/10.4236/pst.2014.22014
  59. Khan H, Pilitsis JG, Prusik J, Smith H, McCallum SE. Pain Remission at One-Year Follow-Up with Spinal Cord Stimulation. Neuromodulation. 2018 Jan;21(1):101-105. https://doi.org/10.1111/ner.12711
Contact the author
Email
Message
The publishing house "Media Sphere" does not provide treatment services, does not give recommendations on contacting medical institutions and specific specialists, on the prescription of medicines and dietary supplements.

Email Confirmation

An email was sent to test@gmail.com with a confirmation link. Follow the link from the letter to complete the registration on the site.

Email Confirmation

Contact us
If you have any questions, complaints or suggestions, please use this feedback form.
Email
Message
The publishing house "Media Sphere" does not provide treatment services, does not give recommendations on contacting medical institutions and specific specialists, on the prescription of medicines and dietary supplements.
Submit Application

You can become an author of one of our magazines, send a request and we will consider it in during the day.

Name
Phone
E-mail
Message
Login
Registration
E-mail
Password
Forgot Password?

Log in to the site using your account in one of the services

Password recovery
E-mail
Login
Register

We use cооkies to improve the performance of the site. By staying on our site, you agree to the terms of use of cооkies. To view our Privacy and Cookie Policy, please. click here.