Sacral Neuromodulation is an Effective Treatment for Interstitial Cystitis/Bladder Pain Syndrome

摘要

Interstitial cystitis (IC)/bladder pain syndrome (BPS) is a syndrome of chronic pelvic pain and voiding dysfunction with significant controversy about diagnosis and treatment. Pelvic floor dysfunction is prevalent in patients with IC, and the impact of this association on symptoms cannot be overstated. Myofascial pain and hypertonic pelvic floor dysfunction are present in as many as 85% of patients with IC and/or chronic pain syndromes, resulting in pelvic pain, dyspareu-nia and voiding and bowel dysfunction. Schmidt and Vapnek performed urodynamics in patients with IC or severe urgency and frequency, and observed that pain episodes paralleled behavioral changes in the sphincter more than in the bladder. Pressure was applied to pelvic floor muscles, eliciting pain to the suprapubic area, perineum, rectum and labia. Interestingly, symptoms improved after neuro-stimulation or biofeedback. Therefore, it is imperative that clinicians conduct a thorough evaluation when treating patients with chronic pelvic pain since therapies directed to the pelvic floor rather than to the bladder may be highly effective.