M L Sharma Consultant in Pain Medicine and Neuromodulation, Liverpool 26/03/2019
26/03/2019
Clear pathway Patient selection (MDT) Trial of SNS Implantation of SNS Outcomes Offered to only for a small number of refractory cases with huge impact on QOL 26/03/2019
Bladder instability (OAB) Faecal incontinence Pelvic pain +/- above symptoms Medically refractory as assessed by referrers Large MDT 26/03/2019
Under local and sedation Under 60 min Day case procedure Need for programming 26/03/2019
Perineal pain Pudendal neuralgia Vulvodynia Coccygodynia Abdomino-pelvic pain Interstitial cystitis Rectal pain/proctalgia fugax Chronic pelvic pain 26/03/2019
Retrospective notes review Age, duration of pain Pain intensity and type Psychological factors (anxiety, depression) Localised or diffuse pain Post surgical or not Physical disability 26/03/2019
26/03/2019
12 patients implanted with SNS for pain 7 successful Percentage Reduction in average Numeric Rating Pain 4 had >50% pain relief Scores (1 Year after SNS Implant) 3 had 30-35% pain relief 70 60 50 40 30 20 10 0 Average Pain Worst Pain Group A Group B 26/03/2019
Baseline Data (Potential Predictors) 70 60 50 40 30 20 10 0 Age in years Duration of pain BPI (Interference HADS (Anxiety HADS ODI (Mean) Localized pain (Mean) years (Mean) Mean) Mean) (Depression (%age of Mean) patients) Group A Group B 26/03/2019
Though all patients had successful trial of SNS, only 60% had meaningful long term success No correlation between baseline anxiety, depression, disability and outcomes with SNS Localized pain description better predictors of response 26/03/2019
We now share this data with potential new patients Prospective audit with improved dataset 26/03/2019
Thank you manoharpain@yahoo.co.uk 26/03/2019
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