Implantable Devices for the Treatment of Pelvic Pain

Abstract Given that chronic pelvic pain (CPP) can be nociceptive, neuropathic, or occur in the absence of an actual injury (similar to complex regional pain syndrome), patients may improve with stimulation of the central nervous system. Spinal cord stimulation has been successfully used for many years in patients with chronic neuropathc pain who have failed conservative treatment options or even surgery. Sacral stimulation has been proven to be effective in alleviating the symptoms of frequency and urgency in patients with pelvic pain. In patients in whom spinal/peripheral stimulation is not indicated or is contraindicated intrathecal delivery of medications through an intrathecal pump may be considered. This chapter will first address various stimulation modalities, including sacral nerve stimulation and spinal cord stimulation, as well as intrathecal delivery of opioids for patients with CPP.