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骶神经调节:晚期子宫内膜异位症慢性盆腔疼痛的探索

Sacral Neuromodulation: Foray into Chronic Pelvic Pain in End Stage Endometriosis.

作者信息

Lavonius Maija, Suvitie Pia, Varpe Pirita, Huhtinen Heikki

机构信息

Department of Digestive Surgery and Department of Gynecology and Obstetrics, Turku University Hospital, Turku, Finland.

出版信息

Case Rep Neurol Med. 2017;2017:2197831. doi: 10.1155/2017/2197831. Epub 2017 Mar 6.

Abstract

Excision of all endometriotic lesions is the method of choice in the treatment of severe endometriosis resistant to medical therapy. The infiltrating nature of the disease as well as extensive surgery may, however, cause chronic pain that cannot be relieved by either surgery or hormonal treatment. As a pilot treatment, we tested the effect of sacral neuromodulation (SNM) for four endometriosis patients suffering chronic pelvic pain and pelvic organ dysfunction after radical surgical treatment. Three out of four patients reported improvement in their symptoms during the neuromodulation testing period and a permanent pulse generator was installed. After 2.5 years, all three patients report better quality of life and want to continue with SNM.

摘要

切除所有子宫内膜异位病灶是治疗对药物治疗耐药的重度子宫内膜异位症的首选方法。然而,该疾病的浸润性以及广泛的手术可能会导致慢性疼痛,而手术或激素治疗均无法缓解这种疼痛。作为一种试验性治疗,我们对4例在根治性手术治疗后患有慢性盆腔疼痛和盆腔器官功能障碍的子宫内膜异位症患者进行了骶神经调节(SNM)效果测试。4例患者中有3例在神经调节测试期间报告症状有所改善,并安装了永久性脉冲发生器。2.5年后,所有3例患者均报告生活质量有所提高,并希望继续接受SNM治疗。

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本文引用的文献

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ESHRE guideline: management of women with endometriosis.ESHRE 指南:子宫内膜异位症女性的管理。
Hum Reprod. 2014 Mar;29(3):400-12. doi: 10.1093/humrep/det457. Epub 2014 Jan 15.
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Sacral nerve modulation in the treatment of chronic pelvic pain.骶神经调节治疗慢性盆腔疼痛。
Int J Colorectal Dis. 2012 Jul;27(7):921-6. doi: 10.1007/s00384-011-1394-2. Epub 2011 Dec 29.
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Clinical practice. Endometriosis.临床实践。子宫内膜异位症。
N Engl J Med. 2010 Jun 24;362(25):2389-98. doi: 10.1056/NEJMcp1000274.

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