Geburtshilfe Frauenheilkd 2022; 82(10): e124
DOI: 10.1055/s-0042-1756949
Abstracts | DGGG

Interdisciplinary Laparoscopic Implantation of neuromodulAtion leadS to the sacral plexus (ILIAS) as therapeutical option of chronic pelvic pain and neurogenic bladder dysfunctions

I Meinhold-Heerlein
1   Justus Liebig Universität, Klinik für Frauenheilkunde und Geburtshilfe, Gießen, Deutschland
,
F Zeppernick
1   Justus Liebig Universität, Klinik für Frauenheilkunde und Geburtshilfe, Gießen, Deutschland
,
J Baumann
1   Justus Liebig Universität, Klinik für Frauenheilkunde und Geburtshilfe, Gießen, Deutschland
,
L Tschapek
1   Justus Liebig Universität, Klinik für Frauenheilkunde und Geburtshilfe, Gießen, Deutschland
,
H-R Tinneberg
1   Justus Liebig Universität, Klinik für Frauenheilkunde und Geburtshilfe, Gießen, Deutschland
,
M Kolodziej
2   Justus Liebig Universität, Klinik für Neurochirurgie, Gießen, Deutschland
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Chronic pelvic pain (CPP) affects the female population in about 4-15 % after all gynecological treatments. Endometriosis or endometriosis treatment represent a frequent reason for CPP. After multiple operations a surgery-associated morbidity like bladder or bowel dysfunctions may remain due to the damage of nerval structures.

We adopted Marc Possover’s LION procedure and chose an interdisciplinary and interprofessional surgical approach to stimulate the sacral nerve and provide a safe treatment option.

The surgical procedure with implantation of the electrode and the parameters of neurostimulation were performed as described (Kolodziej et al., 2020). The history of the pre- and the postoperative status (after 1 day, 3 and 6 months) was taken with detailed information of pain intensity (NRS), bladder function, general health status (EQ-5D-5L), depression (Becks Depression Inventory, BDI-V), and overall pain (Pain Catastrophizing Scale, PCS).

We evaluated the treatment results of 10 patients. Even in our follow-up of 6 months a significant pain relief was detected (NRS: 9 preoperatively to 2.5 after 6 months; PCS: from 37-40 to 4-11). In addition, the quality of life improved (EQ-5D-5L) and we found a significant reduction of depression in all patients (BDI-V).

General treatment satisfaction of chronic pain patients was recorded with the Client Satisfaction Questionnaire (CSQ-8) and showed a high satisfaction with the median of 30.

The ILIAS method is a very effective treatment option for chronic pelvic pain and bladder dysfunctions after endometriosis treatment if conservative treatments fails. The method requires an interdisciplinary and interprofessional team and deserves further evaluation.



Publication History

Article published online:
11 October 2022

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