Penile Pain With Allodynia Following Spinal Cord Stimulation (SCS) Implant: A Case Report.

Abstract

Background: Spinal cord stimulation (SCS) is commonly utilized for managing chronic intractable pain associated with spinal conditions, complex regional pain syndrome (CRPS), neuropathic pain, and peripheral neuropathy. Although rare, complications such as dermatologic reactions and lead-related allergies have been reported. However, penile pain with allodynia has not been previously documented. We present a unique case of penile pain with allodynia following successful SCS implantation and initial pain relief.

Case report: A 53-year-old man underwent implantation of a Boston Scientific spinal cord stimulator with leads positioned at the T8 level, covering the T9-T10 interspace. This followed a successful trial that resulted in 70% pain relief and functional improvement for chronic low back and lower extremity pain due to post-laminectomy syndrome. Following the permanent implant, the patient experienced approximately 40% relief over two months. Subsequently, the stimulator stopped providing effective relief, and he reported ongoing low back pain along with the new onset of penile pain. Despite multiple reprogramming attempts, he developed significant anxiety over his symptoms. Dermatological and urological evaluations were unremarkable. Pharmacologic interventions, including Gabapentin and Pregabalin, were ineffective. He also trialed THC and opioids without relief. The penile pain persisted regardless of whether the stimulator was active. After comprehensive discussions and shared decision-making, the stimulator was explanted. Post-surgery, the patient recovered well, and his penile discomfort resolved immediately.

Conclusion: SCS can potentially lead to rare complications such as penile discomfort. In such cases, explantation of the device may be the only effective resolution.