RADIOFREQUENCY TREATMENT OF CHRONIC PELVIC PAIN MANAGEMENT IN INTERSTITIAL CYSTITIS
Condition: Interstitial Cystitis, Chronic
MeSH terms: Cystitis; Cystitis, Interstitial; Pelvic Pain
Study type: Observational

Summary: 
      Interstitial cystitis/painful bladder syndrome is a collection of symptoms that includes
      urinary urgency, urge incontinence, nocturia, and painful urination. Various treatment
      modalities are utilized in the management of the disease. Superior hypogastric plexus block,
      which is used in the treatment of chronic pelvic pain, is one of these treatment methods.
      Additionally, tibial nerve stimulation is used in the treatment of urinary symptoms. This
      study aims to compare the effectiveness of superior hypogastric plexus pulsed radiofrequency
      and adjunctive transcutaneous tibial nerve stimulation in the treatment of patients with
      interstitial cystitis
    


Intervention name(s): superior hypogastric plexus pulsed radiofrequency and transcutaneous tibial nerve stimulation; superior hypogastric plexus pulsed radiofrequency
Intervention type(s): Procedure; Procedure
Intervention description(s): The L5-S1 intervertebral space was visualized using fluoroscopy. A 22G, 15 cm injection needle was advanced along the bilateral disc, and under lateral imaging, the needle position was confirmed anterior to the vertebral bodies. 2 ml of contrast solution was injected to confirm the correct needle placement, and then 8 mg of dexamethasone and 40 mg of bupivacaine (0.25%) were injected separately on each side. Two weeks later, patients who showed more than 50% improvement from the diagnostic block, as assessed by NRS, underwent a superior hypogastric pulsed radiofrequency procedure using a transdiscal technique with a 22G, 15 cm, 10 mm active-tipped radiofrequency needle at 42°C for 120 seconds. Two 50x50 mm electrode pads were placed on the posterior-superior aspect of the medial malleolus for posterior tibial nerve stimulation. Stimulation was delivered in continuous mode at a frequency of 20 Hz and a pulsed width of 200 ms. It was applied once a week for 30 min for 4 weeks.; The L5-S1 intervertebral space was visualized using fluoroscopy. A 22G, 15 cm injection needle was advanced along the bilateral disc, and under lateral imaging, the needle position was confirmed anterior to the vertebral bodies.
After negative aspiration of blood, 2 ml of contrast solution was injected to confirm the correct needle placement, and then 8 mg of dexamethasone and 40 mg of bupivacaine (0.25%) were injected separately on each side.
Two weeks later, patients who showed more than 50% improvement from the diagnostic block, as assessed by NRS, underwent a superior hypogastric pulsed radiofrequency procedure using a trans discal technique with a 22G, 15 cm, 10 mm active-tipped radiofrequency needle at 42°C for 120 seconds.
Observational model: Cohort
Time perspective: Retrospective
Sampling method: Non-Probability Sample
Study population: 
        A total of 34 patients diagnosed with interstitial cystitis by the urology department and
        experiencing symptoms for at least 3 months, who had undergone superior hypogastric nerve
        pulsed radiofrequency by our team, were retrospectively included in the study at the
        Algology Clinic of Hacettepe University Faculty of Medicine. Some of these patients had
        also undergone transcutaneous posterior tibial nerve stimulation.