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

Ivo Meinhold‐Heerlein, F Zeppernick, Jamie Baumann, L Tschapek, H.-R. Tinneberg, Małgorzata Kołodziej
In: Geburtshilfe und Frauenheilkunde · 2022 · vol. 82(10) , pp. e124 · doi:10.1055/s-0042-1756949 · W4307892572
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This paper describes the ILIAS procedure, an interdisciplinary laparoscopic implantation of neuromodulation leads to the sacral plexus, as a therapeutic option for chronic pelvic pain and neurogenic bladder dysfunctions associated with endometriosis.

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This study evaluated the efficacy of the ILIAS procedure, which involves laparoscopic implantation of neuromodulation leads to the sacral plexus, in treating chronic pelvic pain and neurogenic bladder dysfunctions. The researchers assessed ten patients who had previously undergone gynecological treatments, tracking outcomes such as pain intensity, bladder function, and quality of life over a six-month period. Results indicated significant reductions in pain scores and depression levels, alongside improved general health status and high patient satisfaction rates. This paper is centrally about endometriosis — specifically, it addresses the management of chronic pelvic pain and bladder dysfunction that persists or arises following endometriosis treatment or surgery.

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Abstract

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.
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Subscribe to RSS DOI: 10.1055/s-0042-1756949 Interdisciplinary Laparoscopic Implantation of neuromodulAtion leadS to the sacral plexus (ILIAS) as therapeutical option of chronic pelvic pain and neurogenic bladder dysfunctions Authors 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 © 2022. Thieme. All rights reserved. Georg Thieme Verlag Rüdigerstraße 14, 70469 Stuttgart, Germany

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