Effectiveness of transcutaneous electrical nerve stimulation as an adjunct to selected physical therapy exercise program on male patients with pudendal neuralgia: A randomized controlled trial

Abstract

Objective: To assess the effectiveness of Transcutaneous Electrical Nerve Stimulation (TENS) combined with selected physical therapy exercise program on male patients with pudendal neuralgia. Design: A double-blinded randomized controlled study. Setting: Out-patient setting. Participants: Fifty-two male participants with pudendal neuralgia (30–50 years) were allocated randomly into two groups; study and control. The same physical therapy exercises were applied to all participants, plus the same prescribed analgesic medication (Etodolac). Participants in the study group received additional TENS and sham TENS were given to those in control group. Intervention: Intervention lasted for 12 weeks, three sessions per week (60 minutes/session). Outcome measures: Numerical pain rating scale and daily Etodolac intake dose were measured before and after intervention. Results: Statistically significant differences were detected in numerical pain rating scale and daily Etodolac intake in favor of the study group ( P < 0.05). After 12 weeks of intervention, the mean ± SD for numerical pain rating scale and daily Etodolac intake were 4.25 ± 1.9 and 259.25 ± 84.4 mg, in the study group, and 6.22 ± 2.22 and 355.55 ± 93.36 mg in the control group, respectively. The mean difference (95% CI) for numerical pain rating scale and daily Etodolac intake was −1.97 (−3.09: −0.83) and −96.3 (−144.9: −47.69), between groups post treatment, respectively. Conclusion: Adding TENS to physical therapy exercise program is more effective than physical therapy program alone in improving pain in male patients with pudendal neuralgia as measured by numerical pain rating scale and daily analgesic intake dose.

Cometario al artículo: Radiofrecuencia pulsada del nervio pudendo: una técnica eficaz en la que debemos avanzar en el abordaje.

“…Cuando la causa de NPu es por atrapamiento podemos utilizar los criterios de Nantes que favorecen la identificación y correcta implementación de intervenciones (Tabla I). Al realizar una radiofrecuencia pulsada debemos diagnosticar a un paciente refractario a las intervenciones farmacológicas y de rehabilitación, las cuales no deberían ser suspendidas al realizar este procedimiento ya que algunos medicamentos neuromodulares e intervenciones específicas como la estimulación eléctrica nerviosa transcutánea han mostrado alguna efectividad que puede sumarse a la respuesta clínica de este nuevo procedimiento 4 .…”