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Spinal cord stimulation for intractable vulvar pain. A case report
James L Whiteside1, Mark D Walters, Nagy Mekhail
1Departments of Obstetrics and Gynecology and of Pain Management, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195, USA. whitesj1@ccf.org
Background:
Vulvodynia is a complex pain syndrome with few effective treatments. We present a case of complex persistent vulvar pain effectively managed with spinal cord stimulation.
Case:
A 21-year-old woman had a long history of burning vulvar pain exacerbated by exercise and sexual intercourse. Her symptoms began after termination of pregnancy and were not improved by diet changes or medical therapy. A partial vulvar vestibulectomy with Bartholin gland excision was performed, without an improvement. After referral to a pain management specialist, the patient had temporary relief of symptoms following bilateral hypogastric plexus blocks. With these favorable but temporary results, a permanent spinal cord stimulator was implanted, with sustained symptom relief.
Conclusion:
Spinal cord stimulation may offer a new treatment for women with intractable neuropathic vulvar pain.
