Whiteside James L, Walters Mark D, Mekhail Nagy
Departments of Obstetrics and Gynecology and of Pain Management, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195, USA.
J Reprod Med. 2003 Oct;48(10):821-3.
Vulvodynia is a complex pain syndrome with few effective treatments. We present a case of complex persistent vulvar pain effectively managed with spinal cord stimulation.
A 21-year-old woman had a long history of burning vulvar pain exacerbated by exercise and sexual intercourse. Her symptoms began after termination of pregnancy and were not improved by diet changes or medical therapy. A partial vulvar vestibulectomy with Bartholin gland excision was performed, without an improvement. After referral to a pain management specialist, the patient had temporary relief of symptoms following bilateral hypogastric plexus blocks. With these favorable but temporary results, a permanent spinal cord stimulator was implanted, with sustained symptom relief.
Spinal cord stimulation may offer a new treatment for women with intractable neuropathic vulvar pain.
外阴痛是一种复杂的疼痛综合征，有效治疗方法较少。我们报告一例通过脊髓刺激有效治疗的复杂持续性外阴疼痛病例。
一名21岁女性有长期的外阴烧灼样疼痛病史，运动和性交会使其加重。她的症状在终止妊娠后开始，饮食改变或药物治疗均未改善。进行了部分外阴前庭切除术及巴氏腺切除术，但症状未改善。转诊至疼痛管理专家处后，患者在双侧腹下神经丛阻滞术后症状暂时缓解。鉴于这些良好但短暂的效果，植入了永久性脊髓刺激器，症状得到持续缓解。
脊髓刺激可能为患有顽固性神经性外阴疼痛的女性提供一种新的治疗方法。
