Skip to main content
SpringerLink
Log in

Pain in Urology: The Good, the Bad, and the Ugly

  • Chapter
  • First Online:
Anesthesia for Urologic Surgery

  • 1498 Accesses

Abstract

Patients may suffer from acute pain (an acute urinary obstruction) and chronic pain syndromes including neuropathic pain syndromes, chronic pelvic pain (interstitial cystitis, chronic prostatitis, urethritis, epididymo-orchitis), and urogenital neoplasms. Control of pain can be achieved using different approaches including symptom control (pharmacological approach), interruption of nociceptive pathways responsible for pain transmission to the central nervous system (interventional approach), and for cancer patients, anticancer therapies (treatment of the source of the pain by chemotherapy, radiotherapy, or the use of radioisotopes). Additionally, surgery may have a role in the relief of symptoms caused by specific problems, such as obstruction of a hollow viscus, unstable bony structures, and compression of neural tissues. The guiding principle of pain management is to individualize the approach to the patient’s needs. It is of utmost importance that the clinician assesses the benefit and burden associated with the different regimens. The management of pain in patients should include reassessment of both analgesia and side effects to ensure optimal pain relief and quality of life.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Syrjala KL, Donaldson GW, Davis MW, Kippes ME, Carr JE. Relaxation and imagery and cognitive-behavioral training reduce pain during cancer treatment: a controlled clinical trial. Pain. 1995;63:189–98.

    PubMed  CAS  Google Scholar 

  2. Doyle D. Have we looked beyond the physical and psychosocial? J Pain Symptom Manage. 1997;7:302–11.

    Google Scholar 

  3. Merskey H, Bogduk N. Classification of chronic pain: descriptions of chronic pain syndromes and definitions of pain terms. Seattle: IASP Press; 1994.

    Google Scholar 

  4. Jacobson L, Mariano AJ. General considerations of chronic pain. In: Loeser JD, editor. Bonica’s management of pain. Philadelphia: Lippincott Williams & Wilkins; 2001.

    Google Scholar 

  5. Woolf CJ. Pain: moving from symptom control toward mechanism-specific pharmacologic management. Ann Intern Med. 2004;140:441–51.

    PubMed  Google Scholar 

  6. Scholtz J, Woolf CJ. Can we conquer pain? Nat Neurosci. 2002;5(Suppl):1062–7.

    Google Scholar 

  7. Wiertelak EP, Smith KP, Furness L, et al. Acute and conditioned hyperalgesic responses to illness. Pain. 1994;56:227–34.

    PubMed  CAS  Google Scholar 

  8. Turk DC, Sist TC, Okifuji A, et al. Adaptation to metastatic cancer pain, regional/local cancer pain and non-cancer pain: role of psychological and behavioral factors. Pain. 1998;74:247–56.

    PubMed  CAS  Google Scholar 

  9. Portenoy RK, Lesage P. Management of cancer pain. Lancet. 1999;353:1695–700.

    PubMed  CAS  Google Scholar 

  10. Cassel EJ. The nature of suffering. N Eng J Med. 1982;306:639–45.

    CAS  Google Scholar 

  11. Ahles TA, Blanchard EB, Ruckdeschel JC. The multidimensional nature of cancer-related pain. Pain. 1983;17:277–88.

    PubMed  CAS  Google Scholar 

  12. Jensen MP. The validity and reliability of pain measures in adults with cancer. J Pain. 2003;4:2–21.

    PubMed  Google Scholar 

  13. Rosier EM, Iadarola MJ, Coghill RC. Reproducibility of pain measurement and pain perception. Pain. 2002;98:205–16.

    PubMed  Google Scholar 

  14. Kelly AM. The minimum clinically significant difference in visual analogue scale pain score does not differ with severity of pain. Emerg Med J. 2001;18:205–7.

    PubMed  CAS  Google Scholar 

  15. Fosnocht DE, Chapman CR, Swanson ER, Donaldson GW. Correlation of change in visual analog scale with pain relief in the ED. Am J Emerg Med. 2005;23:55–9.

    PubMed  Google Scholar 

  16. Graham B. Generic health instruments, visual analog scales, and the measurement of clinical phenomena. J Rheumatol. 1999;26:1022–3.

    PubMed  CAS  Google Scholar 

  17. Scott DL, Garrood T. Quality of life measures: use and abuse. Ballieres Clin Rheumat. 2000;14:663–87.

    CAS  Google Scholar 

  18. McHorney CA, Ware JE, Lu JFR, Sherbourne CD. The MOS 36-item short-form health survey (SF-36): III. Tests of data quality, scaling assumptions and reliability across diverse patients groups. Med Care. 1992;32:40–66.

    Google Scholar 

  19. Rogers WH, Wittink H, Wagner A, Cynn D, Carr DB. Assessing individual outcomes during outpatient multidisciplinary chronic pain treatment by means of an augmented SF-36. Pain Med. 2000;1:44–54.

    PubMed  CAS  Google Scholar 

  20. Aaronson NK, Ahmedzai S, Berman B. The European Organization for research and treatment of cancer QLQ-C30: a quality of life instrument for use in international clinical trials in oncology. JNCI. 1993;85:365–76.

    PubMed  CAS  Google Scholar 

  21. EuroQol group. EuroQol – a new facility for the measurement of health-related quality of life. Health Policy. 1990;16:199–209.

    Google Scholar 

  22. Ubel PA. What is the price of life and why doesn’t it increase at the rate of inflation? Ann Intern Med. 2003;163:1637–41.

    Google Scholar 

  23. Chibnall JT, Tait RC. The pain disability index: factor structure and normative data. Arch Phys Med Rehabil. 1994;75:1082–6.

    PubMed  CAS  Google Scholar 

  24. Willis WD, Westlund KN. Neuroanatomy of the pain system and of the pathways that modulate pain. J Clin Neurophysiol. 1997;14:2–31.

    PubMed  CAS  Google Scholar 

  25. Westlund KN. Visceral nociception. Curr Rev Pain. 2000;4:478–87.

    PubMed  CAS  Google Scholar 

  26. Romanelli P, Esposito V. The functional anatomy of neuropathic pain. Neurosurg Clin N Am. 2004;15:257–68.

    PubMed  Google Scholar 

  27. Millan MJ. The induction of pain: an integrative review. Prog Neurobiol. 1999;57:1–164.

    PubMed  CAS  Google Scholar 

  28. Lenz FA, Weiss N, Ohara S, Lawson C, Greenspan JD. The role of the thalamus in pain. Suppl Clin Neurophysiol. 2004;57:50–61.

    PubMed  Google Scholar 

  29. Apkarian AV, Bushnell MC, Treede RD, Zubieta JK. Human brain mechanisms of pain perception and regulation in health and disease. Eur J Pain. 2005;9:463–84.

    PubMed  Google Scholar 

  30. Cervero F, Jänig W. Visceral nociceptors: a new world order? Trend NeuroSci. 1992;15:374–8.

    PubMed  CAS  Google Scholar 

  31. Vasavada SP, Comiter CV, Raz S. Painful diseases of the kidney and ureter. In: Loeser JD, editor. Bonica’s management of pain. 3rd ed. Philadelphia: Lippincott Williams & Wilkins; 2001. p. 1309–25.

    Google Scholar 

  32. Häbler HJ, Jänig W, Koltzenburg M. Activation of unmyelinated afferent fibres by mechanical stimuli and inflammation of the urinary bladder in the cat. J Physiol. 1990;425:545–62.

    PubMed  Google Scholar 

  33. Bahns E, Ernsberger U, Jänig W, et al. Functional characteristics of lumbar visceral afferent fibres from the urinary bladder and the urethra in the cat. Pflugers Arch. 1986;407(5):510–8.

    PubMed  CAS  Google Scholar 

  34. Bahns E, Halsband U, Jänig W. Responses of sacral visceral afferent fibres from the lower urinary tract, colon, and anus to mechanical stimulation. Pflugers Arch. 1987;410(3):296–303.

    PubMed  CAS  Google Scholar 

  35. McDonald JS, Alo KM. Pelvic and perineal pain of urologic origin. In: Loeser JD, editor. Bonica’s management of pain. 3rd ed. Philadelphia: Lippincott Williams & Wilkins; 2001. p. 1448–61.

    Google Scholar 

  36. Fall M, Baranowski AP, Elneil S, et al. EAU guidelines on chronic pelvic pain. Eur Urol. 2010;57:35–48.

    PubMed  Google Scholar 

  37. Le BV, Schaeffer AJ. Genitourinary pain syndromes, prostatitis, and lower urinary tract symptoms. Urol Clin N Am. 2009;36:527–36.

    Google Scholar 

  38. Doggweiler-Wiygul R, Blankenschip J, MacDiarmid SA. Review on chronic pelvic pain from a urologic point of view. World J Urol. 2001;19:160–5.

    PubMed  CAS  Google Scholar 

  39. Schaeffer AJ. Etiology and management of chronic pelvic pain syndrome in men. Urology. 2004;63(Suppl 3A):75–84.

    PubMed  Google Scholar 

  40. Dalpiaz O, Kerschbaumer A, Mitterberger M, Pinggera G, Bartsch G, Strasser H. Chronic pelvic pain in women: still a challenge. BJUI. 2008;102:1061–5.

    Google Scholar 

  41. Kavvadias T, Baessler K, Schuessler B. Pelvic pain in urogynaecology. Part I: evaluations, definitions, and diagnoses. Int Urogynecol J. 2011;22:385–93.

    PubMed  Google Scholar 

  42. Janknegt RA, Hassouna MM, Siegel SW, et al. Long-term effectiveness of sacral nerve stimulation for refractory urge incontinence. Eur Urol. 2001;39:101–6.

    PubMed  CAS  Google Scholar 

  43. Paszkiewicz EJ, Siegel SW, Kirkpatrick C, et al. Sacral nerve stimulation in patients with chronic, intractable pelvic pain. Urology. 2001;57(6 Suppl 1):124.

    PubMed  CAS  Google Scholar 

  44. Wu CL, Raja SN. Treatment of acute postoperative pain. Lancet. 2011;377(9784):2215–25.

    PubMed  CAS  Google Scholar 

  45. Apfelbaum JL, Chen C, Mehta SS, Gan TJ. Postoperative pain experience: results from a national survey suggest postoperative pain continues to be undermanaged. Anesth Analg. 2003;97:534–40.

    PubMed  Google Scholar 

  46. Gramke HF, de Rijke JM, van Kleef M, Raps F, Kessels AG, Peters ML, Sommer M, Marcus MA. The prevalence of postoperative pain in a cross-sectional group of patients after day-case surgery in a university hospital. Clin J Pain. 2007;23:543–8.

    PubMed  Google Scholar 

  47. Liu SS, Wu CL. The effect of analgesic technique on postoperative patient-reported outcomes including analgesia: a systematic review. Anesth Analg. 2007;105:789–808.

    PubMed  Google Scholar 

  48. Kehlet H, Jensen TS, Woolf CJ. Persistent postsurgical pain: risk factors and prevention. Lancet. 2006;367:1618–25.

    PubMed  Google Scholar 

  49. Katz J, Clarke H, Seltzer Z. Review article: preventive analgesia: quo vadimus? Anesth Analg. 2011;113:1242–53.

    PubMed  Google Scholar 

  50. Perkins FM, Kehlet H. Chronic pain as an outcome of surgery a review of predictive factors. Anesthesiology. 2000;93:1123–33.

    PubMed  CAS  Google Scholar 

  51. Toussaint K, Yang XC, Zielinski MA, Reigle KL, Sacavage SD, Nagar S, Raffa RB. What do we (not) know about how paracetamol (acetaminophen) works? J Clin Pharm Ther. 2010;35:617–38.

    PubMed  CAS  Google Scholar 

  52. Toms L, McQuay HJ, Derry S, Moore RA. Single dose oral paracetamol (acetaminophen) for postoperative pain in adults. Cochrane Database Syst Rev. 2008. doi:10.1002/14651858.CD004602.pub2.

    PubMed  Google Scholar 

  53. Hyllested M, Jones S, Pedersen JL, Kehlet H. Comparative effect of paracetamol, NSAIDs or their combination in postoperative pain management: a qualitative review. Br J Anaesth. 2002;88:199–214.

    PubMed  CAS  Google Scholar 

  54. Rømsing J, Møiniche S, Dahl JB. Rectal and parenteral paracetamol, and paracetamol in combination with NSAIDs, for postoperative analgesia. Br J Anaesth. 2002;88:215–26.

    PubMed  Google Scholar 

  55. Schug SA, Sidebotham DA, McGuinnety M, Thomas J, Fox L. Acetaminophen as an adjunct to morphine by patient-controlled analgesia in the management of acute postoperative pain. Anesth Analg. 1998;87:368–72.

    PubMed  CAS  Google Scholar 

  56. Naesh O. Back to the future: postoperative pain management beyond COX-2 inhibitors. N Z Med J. 2006;119:U2170.

    PubMed  Google Scholar 

  57. Holdgate A, Pollock T. Systematic review of the relative efficacy of non-steroidal anti-inflammatory drugs and opioids in the treatment of acute renal colic. BMJ. 2004;12:1401.

    Google Scholar 

  58. Brodner G, Van Aken H, Hertle L, Fobker M, Von Eckardstein A, Goeters C, Buerkle H, Harks A, Kehlet H. Multimodal perioperative management–combining thoracic epidural analgesia, forced mobilization, and oral nutrition–reduces hormonal and metabolic stress and improves convalescence after major urologic surgery. Anesth Analg. 2001;92:1594–600.

    PubMed  CAS  Google Scholar 

  59. Maund E, McDaid C, Rice S, Wright K, Jenkins B, Woolacott N. Paracetamol and selective and non-selective non-steroidal anti-inflammatory drugs for the reduction in morphine-related side-effects after major surgery: a systematic review. Br J Anaesth. 2011;106:292–7.

    PubMed  CAS  Google Scholar 

  60. Marret E, Kurdi O, Zufferey P, Bonnet F. Effects of nonsteroidal antiinflammatory drugs on patient-controlled analgesia morphine side effects: meta-analysis of randomized controlled trials. Anesthesiology. 2005;102:1249–60.

    PubMed  CAS  Google Scholar 

  61. Ong CK, Seymour RA, Lirk P, Merry AF. Combining paracetamol (acetaminophen) with nonsteroidal antiinflammatory drugs: a qualitative systematic review of analgesic efficacy for acute postoperative pain. Anesth Analg. 2010;110:1170–9.

    PubMed  CAS  Google Scholar 

  62. Rømsing J, Møiniche S. A systematic review of COX-2 inhibitors compared with traditional NSAIDs, or different COX-2 inhibitors for post-operative pain. Acta Anaesthesiol Scand. 2004;48:525–46.

    PubMed  Google Scholar 

  63. Straube S, Derry S, McQuay HJ, Moore RA. Effect of preoperative Cox-II-selective NSAIDs (coxibs) on postoperative outcomes: a systematic review of randomized studies. Acta Anaesthesiol Scand. 2005;49:601–13.

    PubMed  CAS  Google Scholar 

  64. Juhlin T, Björkman S, Höglund P. Cyclooxygenase inhibition causes marked impairment of renal function in elderly subjects treated with diuretics and ACE-inhibitors. Eur J Heart Fail. 2005;7:1049–56.

    PubMed  CAS  Google Scholar 

  65. Zhang J, Ding EL, Song Y. Adverse effects of cyclooxygenase 2 inhibitors on renal and arrhythmia events: meta-analysis of randomized trials. JAMA. 2006;296:1619–32.

    PubMed  CAS  Google Scholar 

  66. Munsterhjelm E, Niemi TT, Ylikorkala O, Neuvonen PJ, Rosenberg PH. Influence on platelet aggregation of iv parecoxib and acetaminophen in healthy volunteers. Br J Anaesth. 2006;97:226–31.

    PubMed  CAS  Google Scholar 

  67. Strom BL, Berlin JA, Kinman JL, Spitz PW, Hennessy S, Feldman H, Kimmel S, Carson JL. Parenteral ketorolac and risk of gastrointestinal and operative site bleeding: a postmarketing surveillance study. JAMA. 1996;275:376–82.

    PubMed  CAS  Google Scholar 

  68. Targownik LE, Metge CJ, Leung S, Chateau DG. The relative efficacies of gastroprotective strategies in chronic users of nonsteroidal anti-inflammatory drugs. Gastroenterology. 2008;134:937–44.

    PubMed  CAS  Google Scholar 

  69. Trelle S, Reichenbach S, Wandel S, Hildebrand P, Tschannen B, Villiger PM, Egger M, Jüni P. Cardiovascular safety of non-steroidal anti-inflammatory drugs: network meta-analysis. BMJ. 2011;342:c7086.

    PubMed  Google Scholar 

  70. McQuay H, Moore A, Justins D. Treating acute pain in hospital. BMJ. 1997;314:1531–5.

    PubMed  CAS  Google Scholar 

  71. Ballantyne JC, Carr DB, Chalmers TC, Dear KB, Angelillo IF, Mosteller F. Postoperative patient-controlled analgesia: meta-analyses of initial randomized control trials. J Clin Anesth. 1993;5:182–93.

    PubMed  CAS  Google Scholar 

  72. McQuay HJ. Opioid clinical pharmacology and routes of administration. Br Med Bull. 1991;47:703–17.

    PubMed  CAS  Google Scholar 

  73. Madadi P, Ross CJ, Hayden MR, Carleton BC, Gaedigk A, Leeder JS, Koren G. Pharmacogenetics of neonatal opioid toxicity following maternal use of codeine during breastfeeding: a case–control study. Clin Pharmacol Ther. 2009;85:31–5.

    PubMed  CAS  Google Scholar 

  74. Lötsch J. Opioid metabolites. J Pain Symptom Manage. 2005;29:S10–24.

    PubMed  Google Scholar 

  75. Kirchheiner J, Keulen JT, Bauer S, Roots I, Brockmöller J. Effects of the CYP2D6 gene duplication on the pharmacokinetics and pharmacodynamics of tramadol. J Clin Psychopharmacol. 2008;28:78–83.

    PubMed  CAS  Google Scholar 

  76. Thévenin A, Beloeil H, Blanie A, Benhamou D, Mazoit JX. The limited efficacy of tramadol in postoperative patients: a study of ED80 using the continual reassessment method. Anesth Analg. 2008;106:622–7.

    PubMed  Google Scholar 

  77. Marcou TA, Marque S, Mazoit JX, Benhamou D. The median effective dose of tramadol and morphine for postoperative patients: a study of interactions. Anesth Analg. 2005;100:469–74.

    PubMed  CAS  Google Scholar 

  78. Warren PM, Taylor JH, Nicholson KE, Wraith PK, Drummond GB. Influence of tramadol on the ventilatory response to hypoxia in humans. Br J Anaesth. 2000;85:211–6.

    PubMed  CAS  Google Scholar 

  79. Barnung SK, Treschow M, Borgbjerg FM. Respiratory depression following oral tramadol in a patient with impaired renal function. Pain. 1997;71:111–2.

    PubMed  CAS  Google Scholar 

  80. Wilder-Smith CH, Hill L, Wilkins J, Denny L. Effects of morphine and tramadol on somatic and visceral sensory function and gastrointestinal motility after abdominal surgery. Anesthesiology. 1999;91:639–47.

    PubMed  CAS  Google Scholar 

  81. Dahan A, Yassen A, Romberg R, Sarton E, Teppema L, Olofsen E, Danhof M. Buprenorphine induces ceiling in respiratory depression but not in analgesia. Br J Anaesth. 2006;96:627–32.

    PubMed  CAS  Google Scholar 

  82. Klepstad P, Dale O, Kaasa S, Zahlsen K, Aamo T, Fayers P, Borchgrevink PC. Influences on serum concentrations of morphine, M6G and M3G during routine clinical drug monitoring: a prospective survey in 300 adult cancer patients. Acta Anaesthesiol Scand. 2003;47:725–31.

    PubMed  CAS  Google Scholar 

  83. Peng PW, Sandler AN. A review of the use of fentanyl analgesia in the management of acute pain in adults. Anesthesiology. 1999;90:576–99.

    PubMed  CAS  Google Scholar 

  84. Kress HG. Clinical update on the pharmacology, efficacy and safety of transdermal buprenorphine. Eur J Pain. 2009;13:219–30.

    PubMed  CAS  Google Scholar 

  85. Gagliese L, Gauthier LR, Macpherson AK, Jovellanos M, Chan VW. Correlates of postoperative pain and intravenous patient-controlled analgesia use in younger and older surgical patients. Pain Med. 2008;9:299–314.

    PubMed  Google Scholar 

  86. Macintyre PE, Jarvis DA. Age is the best predictor of postoperative morphine requirements. Pain. 1996;64:357–64.

    PubMed  CAS  Google Scholar 

  87. Hudcova J, McNicol E, Quah C, Lau J, Carr DB. Patient controlled opioid analgesia versus conventional opioid analgesia for postoperative pain. Cochrane Database Syst Rev. 2006;4, CD003348.

    PubMed  Google Scholar 

  88. Gan TJ. Risk factors for postoperative nausea and vomiting. Anesth Analg. 2006;102:1884–98.

    PubMed  Google Scholar 

  89. Tiippana EM, Hamunen K, Kontinen VK, Kalso E. Do surgical patients benefit from perioperative gabapentin/pregabalin? A systematic review of efficacy and safety. Anesth Analg. 2007;104:1545–56.

    PubMed  CAS  Google Scholar 

  90. Marret E, Remy C, Bonnet F, Postoperative Pain Forum Group. Meta-analysis of epidural analgesia versus parenteral opioid analgesia after colorectal surgery. Br J Surg. 2007;94:665–73.

    PubMed  CAS  Google Scholar 

  91. Mann C, Pouzeratte Y, Boccara G, et al. Comparison of intravenous or epidural patient-controlled analgesia in the elderly after major abdominal surgery. Anesthesiology. 2000 Feb;92:433–41.

    PubMed  CAS  Google Scholar 

  92. Gupta S, Maheshwari R, Dulara SC. Wound instillation with 0.25% bupivacaine as continuous infusion following hysterectomy. Middle East J Anesthesiol. 2005 Oct;18:595–610.

    PubMed  Google Scholar 

  93. Bianconi M, Ferraro L, Traina GC, et al. Pharmacokinetics and efficacy of ropivacaine continuous wound instillation after joint replacement surgery. Br J Anaesth. 2003;9:830–5.

    Google Scholar 

  94. Buvanendran A, Kroin JS. Multimodal analgesia for controlling acute postoperative pain. Curr Opin Anaesthesiol. 2009;22:588–93.

    PubMed  Google Scholar 

  95. Wu CL, Raja SN. Treatment of acute postoperative pain. Lancet. 2011;377:2215–25.

    PubMed  CAS  Google Scholar 

  96. Treede RD, Jensen TS, Campbell JN, Cruccu G, Dostrovsky JO, Griffin JW, Hansson P, Hughes R, Nurmikko T, Serra J. Neuropathic pain. Redefinition and a grading system for clinical and research purposes. Neurology. 2008;70:1630–5.

    PubMed  CAS  Google Scholar 

  97. Jensen TS, Gottrup H, Sindrup SH, Bach FW. The clinical picture of neuropathic pain. Eur J Pharmacol. 2001;429:1–11.

    PubMed  CAS  Google Scholar 

  98. Chong MS, Bajwa ZH. Diagnosis and treatment of neuropathic pain. J Pain Symptom Manage. 2003;25:S4–11.

    PubMed  Google Scholar 

  99. Rasmussen PV, Sindrup SH, Jensen TS, Bach FW. Symptoms and signs in patients with suspected neuropathic pain. Pain. 2004;110:461–9.

    PubMed  Google Scholar 

  100. Bridges D, Thompson SW, Rice AS. Mechanisms of neuropathic pain. Br J Anaesth. 2001;87:12–26.

    PubMed  CAS  Google Scholar 

  101. Attal N, Bouhassira D. Mechanisms of pain in peripheral neuropathy. Acta Neurol Scand Suppl. 1999;173:12–24.

    PubMed  CAS  Google Scholar 

  102. Bolay H, Moskowitz MA. Mechanisms of pain modulation in chronic syndromes. Neurology. 2002;59:S2–7.

    PubMed  CAS  Google Scholar 

  103. Amir R, Devor M. Ongoing activity in neuroma afferents bearing retrograde sprouts. Brain Res. 1993;630:283–8.

    PubMed  CAS  Google Scholar 

  104. Devor M, Jaenig W, Michaelis M. Modulation of activity in dorsal root ganglion neurons by sympathetic activation in nerve-injured rats. J Neurophysiol. 1994;71:38–47.

    PubMed  CAS  Google Scholar 

  105. Costignan M, Woolf CJ. Pain: molecular mechanisms. J Pain. 2000;1 Suppl 1:35–44.

    Google Scholar 

  106. Dickenson AH, Chapman V, Green GM. The pharmacology of excitatory and inhibitory amino-acid-mediated events in the transmission and modulation of pain in the spinal cord. Gen Pharmacol. 1997;28:633–8.

    PubMed  CAS  Google Scholar 

  107. Woolf CJ, Shortland P, Reynolds M, Ridings J, Doubell T, Coggeshall RE. Reorganization of central terminals of myelinated primary afferents in the rat dorsal horn following peripheral axotomy. J Comp Neurol. 1995;360:121–34.

    PubMed  CAS  Google Scholar 

  108. Tsuda M, Inoue K, Salter MW. Neuropathic pain and spinal microglia: a big problem from molecules in ‘small’ glia. Trends Neurosci. 2005;28:101–7.

    PubMed  CAS  Google Scholar 

  109. Woolf CJ, Mannion RJ. Neuropathic pain: aetiology, symptoms, mechanisms, and management. Lancet. 1999;353:1959–64.

    PubMed  CAS  Google Scholar 

  110. Draisci G, Kaiander KC, Dubner R, Bennett GJ, Iadarola MJ. Up-regulation of opioid gene expression in spinal cord evoked by experimental nerve injuries and in mammation. Brain Res. 1991;560:186–92.

    PubMed  CAS  Google Scholar 

  111. Millan MJ. Descending control of pain. Prog Neurobiol. 2002;66:355–474.

    PubMed  CAS  Google Scholar 

  112. O’Connor AB, Dworkin RH. Treatment of neuropathic pain: an overview of recent guidelines. Am J Med. 2009;122:S22–32.

    PubMed  Google Scholar 

  113. Vranken JH. Mechanisms and treatment of neuropathic pain. Cent Nerv Syst Agents Med Chem. 2009;9:71–8.

    PubMed  CAS  Google Scholar 

  114. Guay DR. Oxcarbazepine, topiramate, levetiracetam, and zonisamide: potential use in neuropathic pain. Am J Geriatr Pharmacother. 2003;1:18–37.

    PubMed  CAS  Google Scholar 

  115. Giller CA. The neurosurgical treatment of pain. Arch Neurol. 2003;60:1537–40.

    PubMed  Google Scholar 

  116. Sanders M, Zuurmond WWA. Safety of unilateral and bilateral percutaneous cervical cordotomy in 80 terminally ill cancer patients. J Clin Oncol. 1995;13:1509–12.

    PubMed  CAS  Google Scholar 

  117. Cameron T. Safety and efficacy of spinal cord stimulation for the treatment of pain: a 20-year literature review. J Neurosurg. 2004;100:254–67.

    PubMed  Google Scholar 

  118. Browna JA, Barbaro NM. Motor cortex stimulation for central and neuropathic pain: current status. Pain. 2003;104:431–5.

    Google Scholar 

  119. WHO. Cancer pain relief. Geneva: WHO; 1986.

    Google Scholar 

  120. Lynch DF, Lynch Jr DF, Pettaway CA. Tumors of the penis. In: Walsh P, Retik AB, Darracott Vaughan E, Wein AJ, editors. Campell’s urology, vol. 4. 8th ed. Philadelphia: Elsevier Science; 2002. p. 2945–82.

    Google Scholar 

  121. Hernes EH, Harstad K, Fosså SD. Changing incidence and delay of testicular cancer in southern Norway (1981–1992). Eur Urol. 1996;30(3):349–57.

    PubMed  CAS  Google Scholar 

  122. Kalso E, Edward JE, Mooreb RA, McQuay HJ. Opioids in chronic non-cancer pain: systematic review of efficacy and safety. Pain. 2004;112:372–80.

    PubMed  CAS  Google Scholar 

  123. Ripamonti C, Bianchi M. The use of methadone for cancer pain. Hematol Oncol Clin North Am. 2002;16:543–55.

    PubMed  Google Scholar 

  124. Vigano A, Fan D, Bruera E. Individualized use of methadone and opioid rotation in the comprehensive management of cancer pain associated with poor prognostic indicators. Pain. 1996;67:115–9.

    PubMed  CAS  Google Scholar 

  125. Kalso E. Oxycodone. J Pain Symptom Manage. 2005;29:S47–56.

    PubMed  CAS  Google Scholar 

  126. Ross FB, Smith MT. The intrinsic antinociceptive effects of oxycodone appear to be kappa opioid receptor mediated. Pain. 1997;73:151–7.

    PubMed  CAS  Google Scholar 

  127. Stevens RA, Ghazi SM. Routes of opioid analgesic therapy in the management of cancer pain. Cancer Control. 2000;7:132–41.

    PubMed  CAS  Google Scholar 

  128. Skaer TL. Practice guidelines for transdermal opioids in malignant pain. Drugs. 2004;6423:2629–38.

    Google Scholar 

  129. Indelicato RA, Portenoy RK. Opioid rotation in the management of refractory cancer pain. J Clin Oncol. 2002;20:348–52.

    PubMed  Google Scholar 

  130. Mercadante S. Opioid rotation for cancer pain: rationale and clinical aspects. Cancer. 1999;86:1856–66.

    PubMed  CAS  Google Scholar 

  131. Kalso E. Improving opioid effectiveness: from ideas to evidence. Eur J Pain. 2005;9:131–5.

    PubMed  CAS  Google Scholar 

  132. Wong RKS, Wiffen PJ. Bisphosphonates for the relief of pain secondary to bone metastases. Cochrane Database Syst Rev 2002; issue 2, art. no.: CD002068. doi:10.1002/14651858.

    Google Scholar 

  133. Smith MR. Zoledronic acid to prevent skeletal complications in cancer: corroborating the evidence. Cancer Treat Rev. 2005;31 Suppl 3:19–25.

    PubMed  Google Scholar 

  134. Ashby M. Radiotherapy in the palliation of cancer. In: Patt RB, editor. Cancer pain. Philadelphia: JB Lippincott Co; 1993. p. 235–49.

    Google Scholar 

  135. Kurman MR. Systemic therapy (chemotherapy) in the palliative treatment of cancer. In: Pat RB, editor. Cancer pain. Philadelphia: JB Lippincott Co; 1993. p. 251–74.

    Google Scholar 

  136. Pons F, Herranz R, Garcia A, et al. Strontium-89 for palliation of pain from bone metastases in patients with prostate and breast cancer. Eur J Nucl Med. 1997;24(10):1210–4.

    PubMed  CAS  Google Scholar 

  137. Pain management in urological cancers. In: Bader P, Echtle D, Fonteyne V, Livadas K, De Meerleer G, Paez Borda A, Papaioannou EG, Vranken JH, editors. Guidelines on pain management. Arnhem: European Association of Urology (EAU); 2010. p. 43–60.

    Google Scholar 

  138. Onofrio BM, Yaksh TL. Long-term pain relief produced by intrathecal morphine infusion in 53 patients. J Neurosurg. 1990;72:200–9.

    PubMed  CAS  Google Scholar 

  139. Sjöberg M, Appelgren L, Einarsson S, et al. Long-term intrathecal morphine and bupivacaine in “refractory” cancer pain. I. Results from the first series of 52 patients. Acta Anaesthiol Scand. 1991;35:30–43.

    Google Scholar 

  140. de Leon-Casasola OA, Lema MJ. Postoperative epidural opioid analgesia: what are the choices? Anesth Analg. 1996;83:867–75.

    PubMed  Google Scholar 

  141. Vranken JH, van der Vegt MH, van Kan HJM, Kruis MR. Plasma concentrations of meperidine and normeperidine following continuous intrathecal meperidine in patients with neuropathic cancer pain. Acta Anaesthesiol Scand. 2005;49:665–70.

    PubMed  CAS  Google Scholar 

  142. Osenbach RK, Harvey S. Neuraxial infusion in patients with chronic intractable cancer and non-cancer pain. Curr Pain Headache Rep. 2001;5:241–9.

    PubMed  CAS  Google Scholar 

  143. Vranken JH, van der Vegt MH, Kal JE, Kruis MR. Treatment of neuropathic cancer pain with continuous intrathecal administration of S (+)–Ketamine. Acta Anaesthesiol Scand. 2004;48:249–52.

    PubMed  CAS  Google Scholar 

  144. Mercadante S. Controversies over spinal treatment in advanced cancer patients. Support Cancer Care. 1998;6:495–502.

    CAS  Google Scholar 

  145. Ischia S, Ischia A, Luzzani A, Toscano D, Steele A. Results up to death in the treatment of persistent cervicothoracic (Pancoast) and thoracic malignant pain by unilateral percutaneous cervical cordotomy. Pain. 1985;21:339–55.

    PubMed  CAS  Google Scholar 

  146. Vaghadia H, Kapnoudhis P, Jenkins LC, Taylor D. Continuous lumbosacral block using a Tuohy needle and catheter technique. Can J Anaesth. 1992;39:75–8.

    PubMed  CAS  Google Scholar 

  147. Douglas I, Bush D. The use of patient-controlled boluses of local anaesthetic via a psoas sheath catheter in the management of malignant pain. Pain. 1999;82:105–7.

    PubMed  CAS  Google Scholar 

  148. Vranken JH, van der Vegt MH, Ubags LH, Pijl AJ, Dzoljic M. Continuous sacral nerve root block in the management of neuropathic cancer pain. Anesth Analg. 2002;95:1724–5.

    PubMed  Google Scholar 

  149. Eisenberg E, Carr DB, Chalmers TC. Neurolytic celiac plexus block for treatment of cancer pain: a meta-analysis. Anesth Analg. 1995;80:290–5.

    PubMed  CAS  Google Scholar 

  150. Lema MJ, Myers DP, de Leon-Casasola O, Penetrante R. Pleural phenol therapy for the treatment of chronic esophageal cancer pain. Reg Anesth. 1992;17:166–70.

    PubMed  CAS  Google Scholar 

  151. Plancarte R, de Leon-Casasola O, El-Helaly M, Allende S, Lema MJ. Neurolytic superior hypogastric plexus block for chronic pelvic pain associated with cancer. Reg Anesth. 1997;22:562–8.

    PubMed  CAS  Google Scholar 

  152. Choi YK, Novembre E. Continuous inferior mesenteric ganglion block for the control of abdominal pain. Reg Anesth Pain Med. 1999;24:358–60.

    PubMed  CAS  Google Scholar 

  153. Plancarte R, Amescua C, Patt RB. Presacral blockade of the ganglion of Walther (ganglion impar). Anesthesiology. 1990;73:A751.

    Google Scholar 

  154. Rowbotham MC, Twilling L, Davies PS, et al. Oral opioid therapy for chronic peripheral and central neuropathic pain. N Eng J Med. 2003;348:1223–32.

    CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Pain Relief Unit, Medical Center Alkmaar and Slotervaartziekenhuis, Amsterdam, Wilhelminalaan 15, Alkmaar, 1815 JD, The Netherlands

    Jan H. Vranken M.D., Ph.D.

Authors
  1. Jan H. Vranken M.D., Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jan H. Vranken M.D., Ph.D. .

Editor information

Editors and Affiliations

  1. Departments of Anesthesiology and Urolog, Icahn School of Medcine at Mount Sinai, New York, New York, USA

    Daniel M. Gainsburg

  2. The Mount Sinai Medical Center, Icahn School of Medicine at Mount Sinai Department of Anesthesiology, New York, New York, USA

    Ethan O. Bryson

  3. The Mount Sinai Medical Center, Icahn School of Medicine at Mount Sinai Department of Anesthesiology, New York, New York, USA

    Elizabeth A. M. Frost

Rights and permissions

Reprints and permissions

Copyright information

© 2014 Springer Science+Business Media New York

About this chapter

Cite this chapter

Vranken, J.H. (2014). Pain in Urology: The Good, the Bad, and the Ugly. In: Gainsburg, D., Bryson, E., Frost, E. (eds) Anesthesia for Urologic Surgery. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-7363-3_14

Download citation

  • DOI: https://doi.org/10.1007/978-1-4614-7363-3_14

  • Published:

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4614-7362-6

  • Online ISBN: 978-1-4614-7363-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation