ID:15782 Dorsal Root Ganglion Stimulation for Chronic Penile Pain and Fecal Urge With Incontinence

Abstract

We present the case of a 58-year-old man who underwent DRG stimulation for chronic penile pain with unexpected resolution of fecal urge with incontinence. He initially presented with 8 months of penile pain, 10 years of fecal urgency, and 5 years of fecal incontinence. He had minimal benefit with pelvic physical therapy, Sitz baths, and medications via oral, transdermal, and rectal routes. Magnetic resonance imaging (MRI) lumbar neurogram was unremarkable, and MRI total spine was notable for severe right neuroforaminal narrowing at L4-5. Anorectal manometry and pudendal nerve terminal motor latency testing revealed signs of pelvic floor dyssynergia, including paradoxical puborectalis muscle contraction with Valsalva maneuver and altered rectal sensation. He had minimal relief with bilateral pudendal nerve blocks, left S2 and S3 selective nerve root blocks, and trigger point injections of the left puborectalis muscle.