Some pelvic pain syndromes are very resistant to medical treatment. Several studies have demonstrated that sacral neuromodulation, which has been successfully used for the treatment of bladder dysfunction, incontinence, urinary retention and urinary frequency -, can be successfully used for the treatment of chronic pelvic pain -. Several studies have also demonstrated significant involvement of dorsal column pathways in the transmission of visceral pelvic pain  and the successful use of spinal cord stimulation for the treatment of chronic pelvic pain . We report three cases of severe chronic pelvic pain that failed conservative treatment modalities. Placement of a combined sacral nerve roots stimulator and a low thoracic spinal cord stimulator resulted in a significant pain relief and improvement in daily life activities. We believe that this combination may help patients suffering from chronic pelvic pain resistant to medical management.
Cite this paper
Abdel-Aziz, S. and Ghaleb, A. (2014) Combined Sacral Nerve Roots Stimulation and Low Thoracic Spinal Cord Stimulation for the Treatment of Chronic Pelvic Pain. Pain Studies and Treatment
, 86-90. doi: 10.4236/pst.2014.22014
 Van Kerrebroeck, P.E. (2010) Advances in the Role of Sacral Nerve Neuromodulation in Lower Urinary Tract Symptoms. International Urogynecology Journal, 21, S467-S474.
 Mayer, R.D. and Howard, F.M. (2008) Sacral Nerve Stimulation: Neuromodulation for Voiding Dysfunction and Pain. Neurotherapeutics, 5, 107-113. http://dx.doi.org/10.1016/j.nurt.2007.10.063
 Powell, C.R. and Kredert, K.J. (2010) Long-Term Outcomes of Urgency-Frequency Syndrome Due to Painful Bladder Syndrome Treated with Sacral Neuromodulation and Analysis of Failures. Journal of Urology, 183, 173-176.
 Maher, C.F., Carey, M.P., Dwyer, P.L., et al. (2001) Percutaneous Sacral Nerve Root Neuromodulation for Intractable Interstitial Cystitis. Journal of Urology, 165, 884-886. http://dx.doi.org/10.1016/S0022-5347(05)66551-2
 Seigel, S., Paszkiewicz, E., Kirkpatrick, C., et al. (2001) Sacral Nerve Stimulation in Patients with Chronic Intractable Pelvic Pain. Journal of Urology, 166, 1742-1745. http://dx.doi.org/10.1016/S0022-5347(05)65665-0
 Everaert, K., Devulder, J., De Muynck, M., et al. (2001) The Pain Cycle: Implications for the Diagnosis and Treatment of Pelvic Pain Syndromes. International Urogynecology Journal, 12, 9-14. http://dx.doi.org/10.1007/s001920170087
 Yang, K.S., Kim, Y.H., Park, H.J., et al. (2010) Sacral Nerve Stimulation for the Treatment of Chronic Intractable Anorectal Pain: A Case Report. Korean Journal of Pain, 23, 60-64. http://dx.doi.org/10.3344/kjp.2010.23.1.60
 Palacek, J. and Wilis, W.D. (2003) The Dorsal Column Pathway Facilitates Visceromotor Responses to Colorectal Dis- tention after Colon Inflammation in Rats. Pain, 104, 501-507. http://dx.doi.org/10.1016/S0304-3959(03)00075-7
 Kapural, L., Narouze, S.N., Janicki, T.I., et al. (2006) Spinal Cord Stimulation Is an Effective Treatment for the Chronic Intractable Visceral Pelvic Pain. Pain Medicine, 7, 440-443.
 Steege, J.F. (1999) Scope of the Problem. In: Steege, J.F., Metzger, D.M., Levy, B.S., Eds., Chronic Pelvic Pain: An Integrated Approach, W.B. Saunders, Philadelphia, 9.
 Janicki, T.I. (2003) Chronic Pelvic Pain as a Form of Complex Regional Pain Syndrome. Clinical Obstetrics and Gy- necology, 46, 797-803. http://dx.doi.org/10.1097/00003081-200312000-00009
 Kothari, S. (2007) Neuromodulation Approaches to Chronic Pelvic Pain and Coccydynia. Acta Neurochir Supplement, 97, 365-371.
 Fariello, J.Y. and Whitmore, K. (2010) Sacral Neuromodulation for IC/PBS, Chronic Pelvic Pain, and Sexual Dysfunction. International Urogynecology Journal, 21, 1553-1558.
 Feler, C.A., Whitworth, L.A. and Fernandez, J. (2003) Sacral Modulation for Chronic Pain Conditions. Anesthesiology Clinics of North America, 21, 785-795. http://dx.doi.org/10.1016/S0889-8537(03)00085-3
 Zabihi, N., Mourtzinos, A., Maher, M.G., et al. (2008) Short-Term Results of Bilateral S2-S4 Sacral Neuromodulation for the Treatment of Refractory Interstitial Cystitis, Painful Bladder Syndrome, and Pelvic Pain. International Urogynecology Journal and Pelvic Floor Dysfunction, 19, 553-557. http://dx.doi.org/10.1007/s00192-007-0466-x
 Brookoff, D. and Bennett, D.S. Neuromodulation in Intractable Interstitial Cystitis and Related Pelvic Pain Syndromes. Pain Medicine, 7, S166-S184. http://dx.doi.org/10.1111/j.1526-4637.2006.00132.x
 Nauta, H.J., Soukup, V.M., Fabian, R.H., et al. (2000) Punctate Midline Myelotomy for the Relief of Visceral Cancer Pain. Journal of Neurosurgical Spine, 92, 125-130. http://dx.doi.org/10.3171/spi.2000.92.2.0125