Use of Transcutaneous Electrical Nerve Stimulation in the Management of Bladder Pain Syndrome: 2017 Update
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It is very interesting to look back to 1988 and realize how little was known regarding electrical stimulation or neuromodulation in the management of voiding dysfunction and pelvic pain. The original chapter had sparse data on the use of transcutaneous electrical nerve stimulation (TENS) as a means to improve symptoms of interstitial cystitis. It was suggested that other sites of stimulation such as intravaginal or posterior tibial nerve may improve clinical outcomes. The author commented that the ideal site of stimulation was unknown and research was needed to identify the best stimulation parameters to achieve good clinical outcomes. Since that time, cutaneous stimulation is routinely used, but still with little evidence. It is often physical therapists who use TENS and inferential stimulation units as a multimodal approach to managing chronic pelvic pain. There has been broadened interest in the impact of the pelvic floor and neuromuscular dysfunction as an underlying trigger for pain associated with interstitial cystitis. Thus, neuromodulation is a reasonable modality to offer patients with interstitial cystitis symptoms.
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