Treatment Outcome of Acute Sacral Nerve Stimulation in Functional Anorectal Pain

Gao, Rongqing; Wang, Yafei; Wang, Zhimin; Feng, Lin; Li, Yuantao; Chen, Xinhua; Chen, Lü; Zhang, Hui; Liu, Kailun

doi:10.1111/papr.12751

Cited by 9 publications

(19 citation statements)

References 19 publications

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“…The total effectiveness rate was 96.7%, and the median VAS score reduced from 8 to 3 one year after treatment. Patients also had significant improvement on anal maximum contraction pressure and anal rest pressure (73). Similarly, Falletto et al (74) reported that in 12 patients with idiopathic anal pain, VAS score significantly improved from 8.2 ± 1.7 to 2.2 ± 1.3 (P < 0.001) and 36 Item Short Form Health Survey (SF-36) physical component scores increased from 26.27 ± 5.65 to 38.95 ± 9.08 (P < 0.02) after sacral nerve stimulation during a mean follow-up of 15 months.…”

Section: Inguinal/genital/pelvic Painmentioning

confidence: 91%

“…The management of functional anorectal pain remains a challenge, and SNM treatment was addressed in several studies. In a prospective study by Rongqing et al (73), a total of 120 patients received temporary SNM at the S3 nerve root (2 Hz, 1.50 mA, 0.10 ms). Of these, 75 patients were pain free, 41 improved, and 4 had an ineffective outcome.…”

Section: Inguinal/genital/pelvic Painmentioning

confidence: 99%

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Peripheral Nerve Stimulation in Pain Management: A Systematic Review

Xu¹,

Sun

et al. 2021

Pain Phys

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BACKGROUND: Peripheral nerve stimulation (PNS) has been increasingly used to manage acute and chronic pain. However, the level of clinical evidence to support its use is not clear. OBJECTIVES: To assess the clinical evidence of PNS in the treatment of acute or chronic pain. STUDY DESIGN: A systematic review of the efficacy and safety of PNS in managing acute or chronic pain. METHODS: Data sources were PubMed, Cochrane Library, Scopus, CINAHL Plus, Google Scholar, and reference lists. The literature search was performed up to December 2019. Study selection included randomized trials, observational studies, and case reports of PNS in acute or chronic pain. Data extraction and methodological quality assessment were performed utilizing Cochrane review methodologic quality assessment and Interventional Pain Management Techniques–Quality Appraisal of Reliability and Risk of Bias Assessment (IPM-QRB) and Interventional Pain Management Techniques–Quality Appraisal of Reliability and Risk of Bias Assessment for Nonrandomized Studies (IPM-QRBNR). The evidence was summarized utilizing principles of best evidence synthesis on a scale of 1 to 5. Data syntheses: 227 studies met inclusion criteria and were included in qualitative synthesis. RESULTS: Evidence synthesis based on randomized controlled trials (RCTs) and observational studies showed Level I and II evidence of PNS in chronic migraine headache; Level II evidence in cluster headache, postamputation pain, chronic pelvic pain, chronic low back and lower extremity pain; and Level IV evidence in peripheral neuropathic pain, and postsurgical pain. Peripheral field stimulation has Level II evidence in chronic low back pain, and Level IV evidence in cranial pain. LIMITATIONS: Lack of high-quality RCTs. Meta-analysis was not possible due to wide variations in experimental design, research protocol, and heterogeneity of study population. CONCLUSIONS: The findings of this systematic review suggest that PNS may be effective in managing chronic headaches, postamputation pain, chronic pelvic pain, and chronic low back and lower extremity pain, with variable levels of evidence in favor of this technique. KEY WORDS: Acute pain, chronic pain, neuromodulation, peripheral nerve stimulation

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Section: Inguinal/genital/pelvic Painmentioning

confidence: 91%

Section: Inguinal/genital/pelvic Painmentioning

confidence: 99%

Peripheral Nerve Stimulation in Pain Management: A Systematic Review

Xu¹,

Sun

et al. 2021

Pain Phys

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“…Qualitative analysis of the effect of SNM on CPP Six studies were not included in quantitative analysis. 14,21,26,[28][29][30] Two hundred and sixty patients with CPP across the studies underwent a test phase, 96 were implanted with IPGs. One study did not report IPG implantation, resulting of an implantation rate of 66.7% across remaining studies.…”

Section: Primary Outcomementioning

confidence: 99%

“…28 A study of short-term SNM demonstrated only a temporary improvement in QoL which was not maintained at follow-up regardless of pain symptoms. 14 Complications There were 189 reported complications in 24 studies comprising 1555 patients (Table 2). The most common complications were pain at the implant site (35 cases, 2.2%) (Clavien-Dindo grade I) followed by infection (23 cases, 1.48%) (grade II-IIIb).…”

Section: Secondary Outcomesmentioning

confidence: 99%

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Sacral neuromodulation in the management of chronic pelvic pain: A systematic review and meta‐analysis

Greig

Mak

Furrer

et al. 2023

Neurourology and Urodynamics

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Introduction Sacral neuromodulation (SNM) is a treatment approved for use in several conditions including refractory overactive bladder (OAB) and voiding dysfunction. Chronic pelvic pain (CPP) is a debilitating condition for which treatment is often challenging. SNM shows promising effect in patients with refractory CPP. However, there is a lack of clear evidence, especially in long‐term outcomes. This systematic review will assess outcomes of SNM for treating CPP. Methods A systematic search of MEDLINE, Embase, Cochrane Central and clinical trial databases was completed from database inception until January 14, 2022. Studies using original data investigating SNM in an adult population with CPP which recorded pre and posttreatment pain scores were selected. Primary outcome was numerical change in pain score. Secondary outcomes were quality of life assessment and change in medication use and all‐time complications of SNM. Risk of bias was assessed using the Newcastle Ottawa Tool for cohort studies. Results Twenty‐six of 1026 identified articles were selected evaluating 853 patients with CPP. The implantation rate after test‐phase success was 64.3%. Significant improvement of pain scores was reported in 13 studies; three studies reported no significant change. WMD in pain scores on a 10‐point scale was −4.64 (95% confidence interval [CI] = −5.32 to −3.95, p < 0.00001) across 20 studies which were quantitatively synthesized: effects were maintained at long‐term follow‐up. Mean follow‐up was 42.5 months (0–59). Quality of life was measured by RAND SF‐36 and EQ‐5D questionnaires and all studies reported improvement in quality of life. One hundred and eighty‐nine complications were reported in 1555 patients (Clavien‐Dindo Grade I‐IIIb). Risk of bias ranged from low to high risk. Studies were case series and bias stemmed from selection bias and loss to follow‐up. Conclusion Sacral Neuromodulation is a reasonably effective treatment of Chronic Pelvic Pain and significantly reduces pain and increases patients’ quality of life with immediate to long‐term effects.

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Efficacy of electroacupuncture therapy in patients with functional anorectal pain: study protocol for a multicenter randomized controlled trial

Xue,

Zhou,

Zeng

et al. 2024

Int J Colorectal Dis

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Background Some Chinese scholars have initially explored the efficacy of electroacupuncture at Baliao acupoint in patients with functional anorectal pain (FAP). However, their studies are performed in a single center, or the sample size is small. Therefore, we aim to further explore the efficacy of electroacupuncture at Baliao acupoint on the treatment of FAP. Methods In this multicenter randomized controlled trial, 136 eligible FAP patients will be randomly allocated into an electroacupuncture group or sham electroacupuncture group at a 1:1 ratio. This trial will last for 34 weeks, with 2 weeks of baseline, 4 weeks and 8 weeks of treatment, and 1, 3, and 6 months of follow-up. Outcome assessors and statisticians will be blind. The primary outcome will be clinical treatment efficacy, and secondary outcomes will be pain days per month, quality of life, psychological state assessment, anorectal manometry, pelvic floor electromyography, and patient satisfaction. Discussion Results of this trial will be contributed to further clarify the value of electroacupuncture at Baliao acupoint as a treatment for FAP in the clinic. Trial registration This trial has been registered in Chinese Clinical Trial Registry https://www.chictr.org.cn/ (ChiCTR2300069757) on March 24, 2023.

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Treatment Outcome of Acute Sacral Nerve Stimulation in Functional Anorectal Pain

Cited by 9 publications

References 19 publications

Peripheral Nerve Stimulation in Pain Management: A Systematic Review

Peripheral Nerve Stimulation in Pain Management: A Systematic Review

Sacral neuromodulation in the management of chronic pelvic pain: A systematic review and meta‐analysis

Efficacy of electroacupuncture therapy in patients with functional anorectal pain: study protocol for a multicenter randomized controlled trial

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