In patients with chronic pelvic pain, sacral neuromodulation is effective and safe to reduce pain and improve quality of life.
According to the findings of a systematic review and meta-analysis, sacral neuromodulation is an efficacious and safe treatment for people with chronic pelvic pain refractory to conventional treatments. Julian Greig and other colleagues explored outcomes of sacral neuromodulation for chronic pelvic pain management.
An extensive search of Cochrane Central, Embase, MEDLINE, and clinical trial databases was performed. Studies examining sacral neuromodulation in an adult population with chronic pelvic pain using original data that documented pre- and post-treatment pain scores were chosen. The key endpoint was an alteration in the pain scores. Assessment of quality of life, alteration in medication use, and long-term consequences of sacral neuromodulation were considered secondary endpoints. Using the Newcastle Ottawa Tool for cohort studies, the risk of bias was determined.
A total of 26 publications were chosen from 1026 publications that evaluated 853 chronic pelvic pain-affected people. The rate of implantation following test-phase success was 64.3%. Thirteen trials revealed a substantial improvement in pain levels, whereas three reported no meaningful alteration. In 20 investigations that were quantitatively synthesised, the WMD in pain scores on a scale of 1 to 10 was -4.64. The effects persisted over long-term follow-up.
Follow-up on average lasted 42.5 months. RAND SF-36 and EQ-5D questionnaires were used to assess the quality of life, and improvements were witnessed in all investigations. In 1555 patients, 189 complications were noted. Bias risk varied from minimal to high. Studies were case series, and bias came from loss to follow-up and selection bias. Sacral neuromodulation dramatically lowers pain and improves patients' quality of life with short- to long-term benefits, making it a reasonably efficacious option for pain management in the lower abdomen or pelvis.
Neurourology and urodynamics
Sacral neuromodulation in the management of chronic pelvic pain: A systematic review and meta-analysis
Julian Greig et al.
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