Sacral neuromodulation as a treatment for neuropathic clitoral pain after abdominal hysterectomy

Sacral neuromodulation (SNM) may be beneficial in the treatment of patients with chronic pelvic pain, although it is not an FDA-approved indication. We present a case of a 51-year-old patient that presented with symptoms of lower urinary tract dysfunction and clitoral pain after an abdominal hysterectomy. Electrophysiological evaluation suggested a pudendal nerve lesion. After failure of conservative treatment, she was offered SNM as a treatment for her voiding symptoms. During test stimulation, she experienced only moderate improvement in voiding symptoms, but a striking improvement in pain symptoms. She underwent a two-stage implantation of a neurostimulator with a successful outcome after 6 months' follow-up. The results of this report suggest that SNM may be effective in patients with neuropathic pelvic pain.