Gaj F, Andreuccetti J, Speziali F, Trecca A, Crispino P
Dipartimento di Chirurgia Generale e Trapianti d'Organo, Istituto Paride Stefanini, Università 'La Sapienza' di Roma, Italia.
Clin Ter. 2011;162(4):e111-4.
Chronic pelvic pain is a common problem that has a high impact on quality of life of patients who are affected. The technique of percutaneous neuromodulation by electrical stimulation of the tibial nerve (Percutaneous Tibial Nerve Stimulation PTNS) is described by Stoller for the treatment of overactive bladder syndrome in the 90s is currently being tested in the treatment of chronic pelvic pain.
The study included 35 patients with chronic pelvic pain: 17 were treated with a protocol based on 12 PTNS stimulation sessions performed weekly (Group A), 18 were treated with a protocol based on 12 sessions PTNS stimulation performed 3 times a week (group B). All patients were evaluated before and after treatment, by means of diary quality of life score (I-QoL, SF36) and proctologic examination.
At the end of treatment 11/17 patients (63%) in group A and 12/18 patients (67%) in group B were considered a successes. Overall 4/11 (36%) patients in group A and 5/11 (45%) patients in group B recovered completely after treatment. In both groups, patients reported a subjective improvement after 6-8 stimulation sessions. At follow-up 36/8 months there were more complications.
In conclusion, the use of PTNS in the treatment of chronic pelvic pain shows encouraging results in patients not responding to standard analgesic therapy.
慢性盆腔疼痛是一个常见问题,对受影响患者的生活质量有很大影响。经皮电刺激胫神经神经调节技术(经皮胫神经刺激,PTNS)由斯托勒于20世纪90年代描述用于治疗膀胱过度活动症,目前正在用于慢性盆腔疼痛的治疗测试。
该研究纳入35例慢性盆腔疼痛患者:17例采用每周进行12次PTNS刺激的方案进行治疗(A组),18例采用每周进行3次共12次PTNS刺激的方案进行治疗(B组)。所有患者在治疗前后均通过生活质量日记评分(I-QoL、SF36)和直肠检查进行评估。
治疗结束时,A组11/17例患者(63%)和B组12/18例患者(67%)被认为治疗成功。总体而言,A组4/11例患者(36%)和B组5/11例患者(45%)治疗后完全康复。两组患者均在6-8次刺激疗程后报告主观症状改善。在36/8个月的随访中有更多并发症。
总之,PTNS用于治疗慢性盆腔疼痛在对标准镇痛治疗无反应的患者中显示出令人鼓舞的结果。