High-Frequency Spinal Cord Stimulation at 10kHz (HF10 SCS) for the Treatment of Pelvic Pain Patients
A prospective, single-center, observational data collection study of high-frequency spinal cord stimulation at 10kHz (HF10 SCS) for the Treatment of Pelvic Pain Patients
Dr. Bruce Mitchell
30 participants
Aug 14, 2014
Observational
Conditions
Summary
Chronic pelvic pain (CPP) is one of the most common medical problems among women, though it also affects men with a lower incidence . It is defined as pain in the pelvis that lasts more than six months and affects the patient’s quality of life. There are many potential sources of pelvic pain. Pelvic pain may involve the urinary, reproductive, gastrointestinal, neurological, psychological and musculoskeletal systems. Patients with chronic pelvic pain typically receive multidisciplinary care, including medication (antimicrobials, anti-inflammatories, opioids, muscle relaxants, etc), psychotherapy, physical therapy, and interventional treatments (surgery for distension and ablative procedures). A significant proportion of these patients fail however to derive adequate benefits from these therapies and these CPP patients are often left with few options. Traditional spinal cord stimulation (SCS) is a widely accepted cost-effective therapy for patients with chronic pain, especially in patients with post- surgery back and leg pain. SCS has been used successfully to treat intractable CPP patients. A newer treatment, High-Frequency Spinal Cord Stimulation at 10 kHz (HF10TM SCS) using the Senza system (Nevro Corp, USA) has established itself as a key treatment in treating patients with chronic back pain: data from European and Australian pain centers has shown that HF10 SCS is safe and effective at reducing pain, improving function and sleep, and reducing opioid in patients with predominant back pain. The purpose of this study is to investigate the feasibility of using HF10-SCS to provide pain relief and quality of life improvements to CPP patients.
Eligibility
Inclusion Criteria8
- Have been diagnosed with chronic, intractable pelvic pain, with diagnoses including (but not limited to) painful bladder syndrome, prostadynia, vulvodynia, interstitial cystitis, coccydynia, epididymitis, urogenital pain, perineal pain, pudendal neuralgia, obturator neuralgia, perianal pain, pelvic girdle pain, endometriosis, and colorectal pain.
- Be on stable pain medications, as determined by the Investigator, for at least 28 days prior to enrolling in this study and be willing to stay on those medications with no dose adjustments until activation of the permanently implanted Senza device
- Be 18 years of age or over
- Considering daily activity and rest, have average ‘worst area’ of pelvic pain intensity of equal to or greater than 5 out of 10 cm on the Visual Analog Scale (VAS) at enrollment.
- Undergoing treatment for chronic intractable pelvic pain
- Has made the decision to undergo treatment for their chronic pelvic pain with Senza therapy Willing and able to complete protocol requirements including:
- Willing and able to complete health questionnaires and pain scales as specified in the protocol
- Willing and able to sign the study-specific Informed Consent form
Exclusion Criteria19
- Have plans to enroll in another clinical study during their participation in this study, or are currently enrolled in a clinical study that could interfere in participation in the trial or affect the scientific soundness of this study
- Have a medical condition or pain in other area(s), not intended to be treated with SCS, that could interfere with study procedures, accurate pain reporting, and/or confound evaluation of study endpoints, as determined by the Investigator (such as primary headache diagnosis and fibromyalgia).
- Have evidence of an active disruptive psychological or psychiatric disorder or other known condition significant enough to impact perception of pain, compliance of intervention and/or ability to evaluate treatment outcome, as determined by a psychologist.
- Have a current diagnosis of a progressive neurological disease such as multiple sclerosis, chronic inflammatory demyelinating polyneuropathy, rapidly progressive arachnoiditis, rapidly progressive diabetic peripheral neuropathy, brain or spinal cord tumor, and/or central deafferentation syndrome.
- Have definable neuropathic processes, primary voiding dysfunction, active or recurrent urinary tract infections at a rate equal to or more than 3/year, and/or untreated pelvic pathology.
- Have a current diagnosis of a coagulation disorder, bleeding diathesis that would put patient at any increased risk of bleeding during SCS procedure, progressive peripheral vascular disease or uncontrolled diabetes mellitus.
- Having any clinical evidence mechanical instability or progressive neurologic pathology that warrants surgical intervention.
- Any previous history of surgery on the posterior elements (laminectomy, posterior fusion) that would disrupt/obliterate the posterior epidural space.
- Be benefitting from an interventional procedure and/or surgery to treat pelvic pain (Subjects should be enrolled at least 30 days from last benefit).
- Have had a pelvic laparoscopy procedure within the previous 6 months.
- Have an existing drug pump and/or another active implantable device (switched On or Off) such as a pacemaker or other SCS devices.
- Have a condition currently requiring or likely to require the use of MRI or diathermy.
- Have metastatic malignant disease or active local malignant disease.
- Have a life expectancy of less than 1 year.
- Have an active systemic or local infection.
- Be pregnant (if female and sexually active, subject must be using a reliable form of birth control, be surgically sterile or be at least 2 years post-menopausal).
- Have within 6 months of enrollment a significant untreated addiction to dependency producing medications or have been a substance abuser (including alcohol and illicit drugs).
- Be involved in an injury claim under current litigation.
- Have a pending or approved worker’s compensation claim, and an ongoing planned litigation related to work
Interested in this trial?
Get notified about updates and connect with the research team.
Interventions
Twelve month observation of patients implanted with the Senza System for management of chronic, intractable pelvic pain via spinal cord stimulation (SCS). SCS via the Senza System will be at a dose frequency of 10kHz. Duration will be up to 14 days during the trial period, followed by a 12 month oberservation period for those proceeding to a permanent implant. The leads will be placed at sacral root and conus medullaris during the trial period. The permanent leads will be implanted at sacral root OR conus medullaris, based on the outcome of the trial period. The implantable pulse generator (IPG) is implanted as per standard of care/physician discretion (buttock, lateral flank/axillae etc). The duration of the implant procedure may be 20-40mins. The device will be able to be controlled/turned on/off by the participant within the prescribed settings.
Locations(1)
View Full Details on ANZCTR
For the most up-to-date information, visit the official listing.
ACTRN12614000989640