Vaginal infiltration for relief of neuropathic pain after sacrospinous hysteropexy: First successful mid-term report.

Abstract

Female genital prolapse, especially apical prolapse, significantly affects women's health and quality of life. Sacrospinous hysteropexy is a widely used surgical procedure to address this condition, presenting few postoperative complications. However, one of the reported complications is neuropathic pain resulting from damage to the branches of the pudendal nerve. Despite the frequency of this complication, there are few standardized management alternatives. This article presents a clinical case of a 62-year-old patient who experienced persistent neuropathic pain after a sacrospinous hysteropexy, in whom traditional approaches such as physical therapy and medications were ineffective. Therefore, it was decided to perform a corticosteroid infiltration in the painful sites via the vaginal route with local anesthesia. The patient experienced immediate pain relief, which lasted for months without the need to repeat the infiltration. The available literature is scarce regarding the long-term success of this therapeutic technique, so this case highlights the potential mid-term efficacy of this alternative in managing postoperative neuropathic pain. This case contributes to the growing evidence that corticosteroid infiltration can be a viable option for the treatment of postoperative neuropathic pain, offering an improvement in the quality of life of affected patients. While this case shows an initial successful approach, further research is needed to validate and establish the applicability of vaginal corticosteroid infiltration in similar cases.