General Surgery I, University of Siena, Siena, Italy.
Colorectal Dis. 2012 Apr;14(4):502-7. doi: 10.1111/j.1463-1318.2011.02659.x.
The aim of the study was to evaluate the efficacy of sacral nerve modulation for chronic pelvic pain after pelvic or anal surgery for benign disease.
From January 2004 to December 2009, 17 (14 female; age 56 years) consecutive patients suffering from chronic pelvic pain underwent evaluation for sacral nerve modulation in three pelvic floor units.
The previous surgery included stapled transanal rectal resection (five), hysterectomy (four), haemorrhoidectomy (two), stapled haemorrhoidopexy (one), fistulectomy (one), urethral sphincterotomy (one), appendicectomy (one), discectomy (one) and laparoscopy for endometriosis (one). Eight (47%) patients fulfilled the criteria for definitive implantation and were followed for a mean of 39 months. Using a visual analog pain score, pain levels fell from 8.2 preoperatively to 1.9, 2.1, 2.0 and 1.8 at 6, 12, 24 and 36 months, respectively. Age < 60 years and duration of symptoms of < 24 months were good predictors and stapling was a poor predictor of success.
Sacral nerve modulation seems to be effective over time in some patients with chronic pain related to previous surgery.
本研究旨在评估骶神经调节治疗因良性疾病行盆腔或肛门手术后慢性盆腔疼痛的疗效。
2004 年 1 月至 2009 年 12 月，3 个盆底功能障碍中心的 17 例（14 例女性；年龄 56 岁）慢性盆腔疼痛患者接受了骶神经调节评估。
先前的手术包括吻合器经肛直肠切除术（5 例）、子宫切除术（4 例）、痔切除术（2 例）、吻合器痔固定术（1 例）、肛瘘切除术（1 例）、尿道括约肌切开术（1 例）、阑尾切除术（1 例）、椎间盘切除术（1 例）和子宫内膜异位症腹腔镜手术（1 例）。8 例（47%）患者符合明确植入标准，并随访平均 39 个月。使用视觉模拟疼痛评分，疼痛水平从术前的 8.2 分降至术后 6、12、24 和 36 个月的 1.9、2.1、2.0 和 1.8 分。年龄<60 岁和症状持续时间<24 个月是良好的预测因素，而吻合器是成功的不良预测因素。
骶神经调节在一些与先前手术相关的慢性疼痛患者中似乎随着时间的推移而有效。
