{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T10:11:01Z","timestamp":1768903861833,"version":"3.49.0"},"reference-count":20,"publisher":"BMJ","issue":"11","funder":[{"DOI":"10.13039\/100022877","name":"Nalu Medical","doi-asserted-by":"crossref","award":["NA"],"award-info":[{"award-number":["NA"]}],"id":[{"id":"10.13039\/100022877","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Reg Anesth Pain Med"],"accepted":{"date-parts":[[2023,6,23]]},"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Chronic pelvic pain (CPP) is a pervasive, difficult to treat condition affecting up to 26% of the global female and 8.2% of the global male population. Considered a form of chronic regional pain syndrome (CRPS), it is medically complex and often refractory to multimodal management. Neuromodulation has become increasingly popular in treatment of chronic neuropathic pain conditions, including CPP and CRPS. Dorsal column spinal cord stimulation and dorsal root ganglion stimulation have had some success for managing CPP meanwhile peripheral nerve stimulators (PNS) have been suggested as another viable option. However, few studies in the literature have reported successful use of PNS in treatment of CPP. Here, we detail a possible technique for pudendal PNS lead placement for management of CPP.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Method<\/jats:title>\n                  <jats:p>This article describes a novel cephalad to caudad fluoroscopic guided technique for pudendal nerve PNS lead placement and implantation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>A cephalad to caudal-medial fluoroscopic guided approach as described within to successfully implant a percutaneous pudendal nerve PNS for management of CPP.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The pudendal nerve PNS lead placement technique noted within can be used to avoid many of the important neurovascular structures near the pelvic outlet. Further studies are needed to validate the safety and efficacy of this therapy modality but it may be a viable management option for patients with medically refractory CPP.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/rapm-2023-104551","type":"journal-article","created":{"date-parts":[[2023,7,7]],"date-time":"2023-07-07T01:25:10Z","timestamp":1688693110000},"page":"567-571","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Novel implantation technique for pudendal nerve peripheral nerve stimulation for treatment of chronic pelvic pain"],"prefix":"10.1136","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2848-6255","authenticated-orcid":false,"given":"Christopher M","family":"Lam","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, University of Kansas Medical Center, Kansas City, Kansas, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah A","family":"Keim","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Kansas Medical Center, Kansas City, Missouri, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Usman","family":"Latif","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, University of Kansas Medical Center, Kansas City, Kansas, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2023,7,6]]},"reference":[{"key":"2025101110021909000_48.11.567.1","unstructured":"Dydyk AM , Gupta N . Chronic Pelvic Pain. Treasure Island (FL): StatPearls, 2022."},{"key":"2025101110021909000_48.11.567.2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2021.2631"},{"key":"2025101110021909000_48.11.567.3","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1007\/s11916-020-00927-y","article-title":"Neuromodulation in treating pelvic pain","volume":"25","author":"Hunter","year":"2021","journal-title":"Curr Pain Headache Rep"},{"key":"2025101110021909000_48.11.567.4","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1016\/j.mpmed.2018.03.007","article-title":"Chronic pelvic pain in men","volume":"46","author":"Ramsden","year":"2018","journal-title":"Medicine"},{"key":"2025101110021909000_48.11.567.5","doi-asserted-by":"publisher","DOI":"10.1111\/ner.12208"},{"key":"2025101110021909000_48.11.567.6","first-page":"E531","article-title":"The role of neuromodulation in chronic pelvic pain: a review article","volume":"25","author":"Patel","year":"2022","journal-title":"Pain Physician"},{"key":"2025101110021909000_48.11.567.7","doi-asserted-by":"crossref","first-page":"180","DOI":"10.3390\/brainsci8100180","article-title":"Neuromodulation for pelvic and urogenital pain","volume":"8","author":"Roy","year":"2018","journal-title":"Brain Sci"},{"key":"2025101110021909000_48.11.567.8","doi-asserted-by":"publisher","DOI":"10.1002\/nau.20823"},{"key":"2025101110021909000_48.11.567.9","doi-asserted-by":"publisher","DOI":"10.1002\/nau.20174"},{"key":"2025101110021909000_48.11.567.10","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-410X.2007.07082.x"},{"key":"2025101110021909000_48.11.567.11","doi-asserted-by":"publisher","DOI":"10.1111\/luts.12066"},{"key":"2025101110021909000_48.11.567.12","doi-asserted-by":"crossref","first-page":"S51","DOI":"10.1093\/pm\/pnaa171","article-title":"Peripheral nerve stimulation for pudendal neuralgia: a technical note","volume":"21","author":"Gregory","year":"2020","journal-title":"Pain Med"},{"key":"2025101110021909000_48.11.567.13","doi-asserted-by":"publisher","DOI":"10.1097\/AAP.0000000000000355"},{"key":"2025101110021909000_48.11.567.14","doi-asserted-by":"crossref","first-page":"1376","DOI":"10.1007\/BF02234801","article-title":"New, simple, ultrasound-guided infiltration of the pudendal nerve: topographic basics","volume":"44","author":"Gruber","year":"2001","journal-title":"Dis Colon Rectum"},{"key":"2025101110021909000_48.11.567.15","doi-asserted-by":"crossref","first-page":"769","DOI":"10.1007\/s00276-009-0518-7","article-title":"Surgical anatomy of the extrapelvic part of the pudendal nerve and its applications for clinical practice","volume":"31","author":"Pirro","year":"2009","journal-title":"Surg Radiol Anat"},{"key":"2025101110021909000_48.11.567.16","doi-asserted-by":"publisher","DOI":"10.1002\/ca.980080205"},{"key":"2025101110021909000_48.11.567.17","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1002\/ca.20084","article-title":"Anatomical study of the pudendal nerve adjacent to the sacrospinous ligament","volume":"18","author":"Mahakkanukrauh","year":"2005","journal-title":"Clin Anat"},{"key":"2025101110021909000_48.11.567.18","doi-asserted-by":"crossref","first-page":"727","DOI":"10.1016\/j.ajog.2015.06.009","article-title":"Anatomic variations of pudendal nerve within pelvis and pudendal canal: clinical applications","volume":"213","author":"Maldonado","year":"2015","journal-title":"Am J Obstet Gynecol"},{"key":"2025101110021909000_48.11.567.19","doi-asserted-by":"crossref","first-page":"660","DOI":"10.1016\/j.ajog.2007.08.061","article-title":"Neurovascular anatomy of the sacrospinous ligament region in female cadavers: implications in sacrospinous ligament fixation","volume":"197","author":"Roshanravan","year":"2007","journal-title":"Am J Obstet Gynecol"},{"key":"2025101110021909000_48.11.567.20","doi-asserted-by":"crossref","first-page":"646","DOI":"10.1016\/j.ajog.2016.06.025","article-title":"Inferior gluteal and other nerves associated with sacrospinous ligament: a cadaver study","volume":"215","author":"Florian-Rodriguez","year":"2016","journal-title":"Am J Obstet Gynecol"}],"container-title":["Regional Anesthesia &amp; 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