Secondary Logo

Journal Logo

Institutional members access full text with Ovid®

Management of Urinary and Fecal Incontinence in Patients With Complex Regional Pain Syndrome

Wang, Rui BA*; Lefevre, Roger MD*†

Female Pelvic Medicine & Reconstructive Surgery: January/February 2016 - Volume 22 - Issue 1 - p e14–e16
doi: 10.1097/SPV.0000000000000220
Case Reports
Buy

Background Urinary voiding dysfunction is reported in many patients with complex regional pain syndrome (CRPS). However, there is a gap in the literature for treating patients with CRPS who develop incontinence symptoms.

Case We report a case describing the use of sacral neuromodulation therapy in a patient with urgency urinary and fecal incontinence who had a previously implanted spinal cord stimulator for type 1 CRPS, formerly known as reflex sympathetic dystrophy. Despite initial hesitation and treatment delay, sacral neuromodulation therapy was successful and effective in controlling both fecal and urgency urinary incontinence symptoms for the patient. This intervention continues to provide her with an improved quality of life 10 months after her procedure.

Conclusions In this case, there was significant hesitation from the provider and patient to use invasive treatments for incontinence symptoms when the patient's pain symptoms have been well controlled with an existing spinal device. However, in this patient with type 1 CRPS, even in the setting of an existing spinal cord stimulator, sacral neuromodulation therapy was an effective treatment.

We report a case of a patient with type 1 complex regional pain syndrome who was successfully treated with sacral neuromodulation therapy in the setting of an existing spinal cord stimulator to help address the gap in the literature for effectively treating patients with complex regional pain syndrome who develop incontinence symptoms.

From the *Obstetrics Gynecology & Reproductive Biology, Harvard Medical School; and †Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA.

Reprints: Roger Lefevre, MD, Department Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Kirstein 3, Boston, MA 02115. E-mail: rlefevre@bidmc.harvard.edu.

The authors have declared they have no conflicts of interest.

Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.