PD36-10 LUMBO-SACRAL LOW INTENSITY SHOCKWAVE THERAPY FOR GENITO-PELVIC DYSESTHESIA/PERSISTENT GENITAL AROUSAL DISORDER (GPD/PGAD) USING UROGOLD 100 MTS

Abstract

You have accessJournal of UrologySexual Function/Dysfunction: Female (PD36)1 Apr 2020PD36-10 LUMBO-SACRAL LOW INTENSITY SHOCKWAVE THERAPY FOR GENITO-PELVIC DYSESTHESIA/PERSISTENT GENITAL AROUSAL DISORDER (GPD/PGAD) USING UROGOLD 100 MTS Jessica Yih*, Julea Minton, Catherine Gagnon, Sue Goldstein, and Irwin Goldstein Jessica Yih*Jessica Yih* More articles by this author , Julea MintonJulea Minton More articles by this author , Catherine GagnonCatherine Gagnon More articles by this author , Sue GoldsteinSue Goldstein More articles by this author , and Irwin GoldsteinIrwin Goldstein More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000907.010AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Low intensity shockwave therapy (LiSWT) was introduced to sexual medicine in 2010 as penile shockwave therapy for the non-invasive, non-hormonal, non-pharmacologic treatment of erectile dysfunction. Ever since, sexual medicine clinicians have been broadening LiSWT utilization for bothersome sexual health concerns. LiSWT has been shown to be anti-inflammatory to such processes as radiculitis; researching Pubmed for LiWST treatments of various pain conditions yields over 600 citations. GPD/PGAD is highly associated with despair, emotional lability, catastrophization and suicidality. This study is a retrospective chart review of a highly selected population with distressing GPD/PGAD from suspected radiculitis of sacral spinal nerve roots who were offered lumbo-sacral LiSWT after either minimally invasive spine surgery (MISS) without full resolution of symptoms, were considered to not be a candidate for MISS, or chose not to undergo lumbosacral surgery. METHODS: Patients were selected for treatment who had: 1) distressing symptoms of GPD/PGAD with unrelenting, unprovoked itching, pain or arousal > 6 mo, 2) abnormal neurogenital testing, 3) abnormal lumbo-sacral MRI with degenerative disc disease, herniated nucleus pulposus, annular tear, facet cyst and/or Tarlov cyst; and 4) consultation with a spine surgeon. Treatment involved the UroGold 100 MTS OP155 parabolic probe, Hz 3, energy density 0.06 - 0.10 mJ/mm 2 for 2-4 treatments, with 2100 - 4200 shocks to left and right sacral and lumbar regions. The Patient Global Impression of Improvement (PGI-I) was administered at each office visit starting at the second treatment. RESULTS: Thirteen patients (mean age 38 +/- 11 years) with various symptoms of GPD/PGAD were identified. Seven women had MISS with improvement but not full resolution of their distressing symptoms and 6 did not have spine surgery. Post-treatment, 8/13 (62%) realized improvement of distressing symptoms selecting very much better, much better and somewhat better (PGI-I 1-3). Four patients reported virtual full resolution of GPD/PGAD distressing symptoms with 4-6 months follow-up. The adverse event of temporary worsening of back pain was observed in 5 patients, noted for 1- 14 days post-treatment, that fully resolved. CONCLUSIONS: The initial results of this non-invasive, non-hormonal, non-pharmacologic shockwave energy-based strategy show positive therapeutic benefit for highly selected women with distressing GPD/PGAD secondary to suspected radiculitis of sacral spinal nerve roots. Source of Funding: Not funded. © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e726-e727 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jessica Yih* More articles by this author Julea Minton More articles by this author Catherine Gagnon More articles by this author Sue Goldstein More articles by this author Irwin Goldstein More articles by this author Expand All Advertisement PDF downloadLoading ...