Spinal Cord Stimulation for Loin Pain Hematuria Syndrome: Clinical Report

Abstract

Loin pain hematuria syndrome (LPHS) is a rare condition characterized by cryptogenic debilitating flank pain and microscopic or macroscopic hematuria. The pathophysiology of LPHS remains poorly understood, and diagnosis is made largely by exclusion of alternate pathology. Management strategies can vary widely and include chronic opioid medication and a variety of invasive procedures, including regional nerve blocks, transcutaneous electrical nerve stimulation, local capsaicin infusion, and surgical renal denervation. Neuromodulation may provide a new paradigm of treatment for LPHS, potentially sparing patients from long‐term complications of opiate therapy and invasive surgery. This report demonstrates the first case of successful symptomatic management of LPHS using spinal cord stimulation.

Loin pain haematuria syndrome 1967–2020: a review

“…The assessment used a Numeric Rating Scale which fell from 9 to 0. Similarly, the one SCS patient reported less pain than initially after 26 months [ 21 ] as assessed by a Quality-of-Life Scale which improved from 5 to 10.…”

Basic Research Protocol: Exome Sequencing in Adults With Loin Pain Hematuria Syndrome: A Pilot Study

“…Upon review of 104 LPHS articles included, encompassing 610 LPHS patients, with 68% of the articles and 87% of patients reported from the United States and United Kingdom alone. With all articles published so far focusing on symptomatic pain management using oral narcotic therapy and/or interventional management strategies such as intra-ureteric infusions, [15][16][17] surgical renal denervation, [18][19][20] radiofrequency ablation, [21][22][23] neuromodulation, [24][25][26] and auto-transplantation, [27][28][29][30][31] we did not identify any studies looking at (A) evidence of familial clustering of LPHS or its components, variability in prevalence across different ancestries, or antecedent exposures or condition, or (B) variants in genes coding for proteins that are involved in GEC, GBM, or the pain pathways.…”