Pelvic Pain

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OBGYN.net Conference CoverageFrom American Association of Gynecological LaparoscopistsOrlando, Florida, November 2000

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Dr. James Carter:  “Hi, this is Jim Carter, and I’m here at the AAGL meeting in Orlando. I’m a physician in Mission Viejo, and I happen to be fortunate to be with Dr. Charles Butrick, I call him Chip from Kansas City, Missouri who is an expert in the field of pelvic pain. Chip, could you tell me about some of the new developments in this area of using electricity to help people with pain using what they call neuro-stimulation?”

Dr. Charles Butrick:  “Jim, it’s really fascinating in that we have so many patients that suffer with chronic pain primarily because their spinal cord and the nerves that go to and from that spinal chord are “wound up” or overly excitable. The most common symptom that we’ll see in our practice is the symptom of urgency frequency syndrome, problems of vulvodynia with vagina burning and irritation, and the problems of chronic pain associated with the pelvic floor that tenses up so tightly that it causes constant pain, difficulty urinating, having intercourse, or passing stool. Now, we realize that we need to calm down those nerves that are so overly excitable or what we call ‘up-regulated’ and the best way to calm them down appears to be is neuromodulation. There are several ways to do that but Medtronic, Inc. ( http://www.medtronic.com ) has developed the technology we refer to as ‘InterStim’. These nerves are actually down - regulated through the passage of current through the S3 or S4 nerve roots ( these are nerves down near the tailbone.) There’s a little battery that is then implanted under the skin, typically in the buttocks area, and through that electrode and battery we can program electrical current to calm down these nerves that are obviously the source of the patient’s pain. I’ll sometimes have patients call me within a few hours of the placement of a little wire just in the office to test to see if it works; they’ll call me and say that their interstitial cystitis they’ve had for twenty years is gone.”

Dr. James Carter:  “So this is a device that Medtronics has developed which is really primarily for what we call ‘urgency frequency syndrome’ - people with urgency and frequency of urination but it also has been found to be effective in the hands of very skilled practitioners in pain areas. This is a very exciting development, I understand that if people are interested in how they can get their problems resolved with this urgency frequency syndrome or with their pelvic pain, they can contact you in Kansas City, Missouri at your clinic. Which group are you with?”

Dr. Charles Butrick:  “I’m the Director of the Urogynecology Center and that’s part of a private practice outside of Kansas City in Lenexa, Kansas but they can also contact through the website that Medtronics offers a very nice chat room and education about InterStim.”

Dr. James Carter:  “Thank you very much. I have to speak with personal thanks for Dr. Butrick, he took care of my niece who was in Kansas City, and I really thank you for all the help you gave her.”

Dr. Charles Butrick:  “Thank you, Jim.”

Dr. James Carter:  “Thank you, Chip.”

 

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