Management Modalities of Chronic Pelvic Pain
Laparoscopic Presacral Neurectomy Versus Fluoroscopically Guided Superior Hypogastric Plexus Neurolysis for Treatment of Chronic Pelvic Pain: A Double-Blind, Randomized Controlled Trial.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Mohamed Ahmed Wasfy, MD
- Phone Number: 01226340453
- Email: Mo.a.wasfy@gmail.com
Study Contact Backup
- Name: Abdalla Gouda, MD
- Phone Number: 01114166085
- Email: drabdogoda@gmail.com
Study Locations
-
-
Al-Sharkia
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Zagazig, Al-Sharkia, Egypt, 44519
- Zagazig University Hospital
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Patient acceptance.
- Body mass index < 35 kg/m2.
- Adult patients with chronic pelvic and perineal pain due to pelvic cancer.
- Visual Analog Scale pain score ≥ 5 on a 0-10 scale despite treatment with a standard analgesic.
Exclusion Criteria:
- Uncooperative patient.
- Patients with coagulopathy, infection at the site of injection, severe cardiac compromise, or intolerance to sympathetic block.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Active Comparator: Laparoscopic Presacral Neurectomy
The patients will undergo Laparoscopic Presacral Neurectomy under general anesthesia.
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Laparoscopy will be performed under general anesthesia.
Then, nerve plexuses will be identified and freed from their underlying tissue, which contains the left common iliac and middle sacral veins.
This will be followed by cauterization and cutting of the nerve plexuses.
|
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Active Comparator: Fluoroscopically guided Superior Hypogastric Neurolysis
The patients will receive fluoroscopically guided Superior Hypogastric Plexus Neurolysis with Radiofrequency of the Sacral Roots 2,3,4.
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The patients will receive fluoroscopically guided Superior Hypogastric Plexus Neurolysis using 3 mL of 75% ethanol and Radiofrequency of the Sacral nerve Roots 2-4.
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Visual analogue pain score
Time Frame: At the end of the first month after the procedure.
|
The percentage of patients who achieved > 50% decline in their Visual analogue pain score "from the baseline value" before intervention at the end of the first month.
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At the end of the first month after the procedure.
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Daily analgesic requirements
Time Frame: At the end of the first 2 weeks, 1st month, 2nd month, 3rd month, and 6th month after the procedure.
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Daily analgesic requirements at the end of the first 2 weeks, 1st month, 2nd month, 3rd month, and 6th month after the procedure.
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At the end of the first 2 weeks, 1st month, 2nd month, 3rd month, and 6th month after the procedure.
|
|
Associated adverse events
Time Frame: At the end of the first month after the procedure.
|
Any related adverse events "e.g.
hypotension, bleeding or neurological deficits" in the first month after the procedure.
|
At the end of the first month after the procedure.
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Abdalla Mohamed Gouda, MD, Department of Anesthesia, Intensive Care & Pain Management, Zagazig University
Publications and helpful links
General Publications
- Ghai V, Subramanian V, Jan H, Pergialiotis V, Thakar R, Doumouchtsis SK; CHORUS: An International Collaboration for Harmonising Outcomes, Research, Standards in Urogynaecology, Women's Health. A systematic review on reported outcomes and outcome measures in female idiopathic chronic pelvic pain for the development of a core outcome set. BJOG. 2021 Mar;128(4):628-634. doi: 10.1111/1471-0528.16412. Epub 2020 Sep 1.
- de Leon-Casasola OA, Kent E, Lema MJ. Neurolytic superior hypogastric plexus block for chronic pelvic pain associated with cancer. Pain. 1993 Aug;54(2):145-151. doi: 10.1016/0304-3959(93)90202-Z.
- Hetta DF, Mohamed AA, Abdel Eman RM, Abd El Aal FA, Helal ME. Pulsed Radiofrequency of the Sacral Roots Improves the Success Rate of Superior Hypogastric Plexus Neurolysis in Controlling Pelvic and Perineal Cancer Pain. Pain Physician. 2020 Mar;23(2):149-157.
- Soysal ME, Soysal S, Gurses E, Ozer S. Laparoscopic presacral neurolysis for endometriosis-related pelvic pain. Hum Reprod. 2003 Mar;18(3):588-92. doi: 10.1093/humrep/deg127.
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- Pelvic Pain Management
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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