Background and aims Vulvodynia is a complex pathology which causes significant morbidity. Despite this, there is no consensus on how best to approach treatment, with low rates of success. Pulsed radiofrequency (PRF) is a recent method of pain treatment, with growing therapeutic use. However, its effectiveness in treating vulvodynia remains largely unexplored. We present a case-series of two patients treated with PRF to the impar ganglion which alleviated symptoms of chronic pelvic pain.
Methods We assessed each patient’s pain on the Visual Analogue Scale (VAS), reviewed current analgesia, and social impact. We then delivered a single session of PRF to the impar ganglion under x-ray guidance, before follow up.
Results Case 1: 45-year-old woman with an 18 month history of vulvodynia, unsuccessfully treated pharmacologically. Her pain was rated an 8 on the VAS, prevented intercourse, and led to multiple emergency department attendances. After PRF, VAS rating was 0, and the patient was able to stop all analgesic medication and could engage in intercourse. Patient was still pain free 12 months later.
Case 2: 65-year-old woman with a 4 year history of vulvodynia, unsuccessfully treated pharmacologically, rating 8 on the VAS scale. After PRF, her pain was rated at 2 on the VAS scale, and she was able to substantially reduce the dosage of her analgesia.
Conclusions These two cases demonstrate the successful use of PRF of the impar ganglion as a novel technique in treating vulvodynia. This new approach offers an alternative for clinicians treating this difficult to manage condition.
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