Disclosures: Thomas Chai, MD: Nothing to disclose

Case Description: The patient presented to the pain clinic on chronic opioid and adjuvant therapy for her chronic postoperative pelvic pain, still under-controlled. She underwent both pain medication regimen adjustments and serial superior hypogastric plexus blocks, with mixed results. She was deemed then to be an appropriate candidate for dorsal root ganglion (DRG) stimulation trial, with subsequent trial placement of stimulator leads at the bilateral L1 and S2 dorsal root ganglia.

Setting: Tertiary Care Cancer Center

Patient:  A 62-year-old female with oncologic history of breast cancer who presents with chronic pelvic pain due to numerous abdominopelvic surgeries, including Caesarian section, hysterectomy, bladder suspension surgery and revisions, and pelvic laparoscopies.

Assessment/Results: The patient reported at least 80% relief of her long-standing chronic postoperative pelvic pain during the DRG stimulation trial, and subsequently proceeded to DRG stimulation implantation surgery.

Discussion: Neuromodulation of the dorsal root ganglion is an accepted therapy for treating a number of chronic pain conditions that are resistant to conventional treatment methods or to dorsal column stimulation. DRG stimulation has been found useful to target focal areas, for instance groin pain, knee pain, or foot pain; however, there have been reports of successful use of this modality for other pain locations and conditions, such as for chronic pelvic pain. The L1/S2 lead placement has been identified as the configuration that covers best the pelvic area.

Conclusion: DRG stimulation should be considered for chronic, postoperative pelvic pain refractory to conventional analgesic therapy and nerve block procedures.

Level of Evidence: Level V

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/chronic-iatrogenic-pelvic-pain-in-a-breast-cancer-patient-relieved-with-dorsal-root-ganglion-stimulation-a-case-report/