• Title/Summary/Keyword: Chronic perineal pain

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Failure of Urination and Defecation after Intrathecal Phenol-glycerin Block for Management of Chronic Perineal Pain -A case report- (만성회음부 통증 치료를 위한 지주막하 페놀글리세린 차단 후 발생한 배변 및 배뇨장애 -증례 보고-)

  • Ahn, Hyun-Jung;Kim, Jong-Il;Lee, Sang-Gon;Ban, Jong-Seouk;Min, Byung-Woo
    • The Korean Journal of Pain
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    • v.12 no.2
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    • pp.268-271
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    • 1999
  • Intrathecal phenol-glycerin block is a potent tool in stepwise approach to intractable perineal pain. At outpatient clinic, intrathecal phenol-glycerin block have been frequently used to control the cancer pain, as this procedure does not require special equipment. However, undesirable effects may occur with any given intrathecal injection. Although most side effects do not last long, they deserve well to prevent. Recently, we have been controlled the perineal and perianal cancer pain with intrathecal phenol-glycerin block without any specific complications. However, one patient we managed experienced that one patient, with this procedure for chronic non-malignant perineal pain control experience gait disturbance and one-week of voiding and defication difficulties. This research reports these practices, including the review of literature.

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Ganglion Impar Block With Botulinum Toxin Type A for Chronic Perineal Pain -A Case Report-

  • Lim, Su-Jin;Park, Hue-Jung;Lee, Sang-Hoon;Moon, Dong-Eon
    • The Korean Journal of Pain
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    • v.23 no.1
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    • pp.65-69
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    • 2010
  • Chronic perineal pain is an often encountered problem, which produces a great degree of functional impairment and frustration to the patient and a challenge to the treating physician. The reason for this problem is that the region contains diverse anatomic structures with mixed somatic, visceral and autonomic innervations affecting bladder and bowel control and sexual function. A blockade of nociceptive and sympathetic supply to the perineal region, supplied through the ganglion impar has been shown to benefit patients with chronic perineal pain. Several options to this block have been described that chemical neurolysis, radiofrequency ablation etc. Although the analgesic effect of Botulinum toxin type A (BoNT-A) has long been considered secondary to its action for muscle relaxation, BoNT-A also affects the release of the neurotransmitters that are involved in pain perception. We describe a patient who was successfully given ganglion impar block with BoNT-A.

Perineal Pain due to Bladder Stones after Total Abdominal Hysterectomy - A case report - (전 자궁 절제술 후 방광 내 결석으로 유발된 회음부 통증 - 증례보고 -)

  • Park, Sang Hyun;Park, Jong Cook;Lee, Pyung Bok
    • The Korean Journal of Pain
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    • v.20 no.2
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    • pp.251-254
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    • 2007
  • Perineal pain is a significant diagnostic challenge to the pain practitioner, and accurate diagnosis and treatment is essential. We report a case of 42-years old female patient suffering from excruciating vulvodynia for 5 years. Her pain on the visual analogue scale was 10 out of 10 and her pain was associated with sleep disturbance, dyspareunia, and chronic fatigue. She was diagnosed with a bladder stone by imaging, and The pain was relieved by cystolitholapaxy.

A Case Report of Decreased Chronic Coccygodynia from Coccygeal Subluxation after Chuna Manipulation (만성 미골통을 호소하는 미골 후방 아탈구 환자의 추나 치료 치험 1례)

  • Cha, Yun-Yeop;Nam, Tong-Hyun
    • Journal of Korean Medicine Rehabilitation
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    • v.20 no.2
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    • pp.191-197
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    • 2010
  • Coccygodynia is a common problem that is characterized by pain in the tailbone that radiates to the lower sacral and perineal areas. The purpose of this study is to report the pain decrease after Chuna manipulation on a chronic coccygodynia patient. We diagnosed a patient suffering from chronic coccygodynia as subluxation of Co2 below Co1. And we treated for correcting the subluxation with Chuna manipulation. The effectiveness of the Chuna manipulation was evaluated with visual analogue scale(VAS) score and the angle between Co1 and Co2. It was decreased that both VAS score and angle between Co1 and Co2. The effect was maintained for a period of at least 6 months. We concluded that Chuna manipulation has effectiveness on chronic coccygodynia from coccygeal subluxation.

Clinical Report of Two Patients with Chronic Prostatitis (만성 전립선염 환장의 치험 2예)

  • Sim Kuk Jin;Park Hyoung Jin;Cho Cheol Won;Kang Sei Young;Kim Hong Joon;Song Bong Keun
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.18 no.1
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    • pp.274-278
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    • 2004
  • The prostatitis is characterized as relatively incurable, chronic and recurrent illness. Because of this property, we have a difficulty in treating this illness. The purpose of this study is evaluating the efficiency of herb medicine, acupuncture, and herbal acupuncture therapy to the prostatitis. A clinical observation was made on two patients with chronic prostatitis who had perineal pain, pubic pain, testicular pain, painful urination, frequency and dysuria. They were treated with herb medicine, acupuncture, and herbal acupuncture therapy for four weeks and symptoms were considerably decreased. This result suggests that oriental medical therapy is useful enough to treat the prostatic diseases. Therefore the further study of the approach and application of this treatment on prostatitis would be necessary.

Epidural Abscess Following Continuous Epidural Analgesia in Patient with Rectal Cancer -A case report- (직장암환자에서 지속성 경막외차단 후 발생한 경막외 농양 -증례 보고-)

  • Chang, Seong-Ho;Koo, Eun-Hye;Lim, Hae-Ja;Cho, Hun;Lee, Hye-Won;Yoon, Suk-Min
    • The Korean Journal of Pain
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    • v.11 no.1
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    • pp.165-168
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    • 1998
  • Although the incidence of epidural abscess is low, patient requiring continuous epidural analgesia for control of acute and chronic pain is increasing rapidly. Therefore we anticipate more frequent encounters with epidural abscess patients in future. Once epidural abscess formation begins, early diagnosis and treatment is very important to prevent permanent neurologic damage. The authors encountered a case of epidural abscess after continuous epidural analgesia for control of perineal pain due to rectal cancer. Forty-eight hours after the block, patient began to suffer severe low back pain, local tenderness, and fever. So the catheter was removed and culture sensitivity test was done with blood and local drainage. The test results identified methicillin susceptible staphylococcus aureus. Antibiotics were administered. Ten days after the block, left ankle jerk disappeared, and force of dorsiflexion of great toe decreased, but numbness or anesthesia appeared at $L_5$ dermatome. Laminectomy was performed, and abscess and necrotic fat material was removed from left $L_5$ nerve root. The patient was discharged 12 days after operation without any neurologic sequalae.

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The Clinical Study on 40 Cases of Patient with Chronic Prostatitis (만성전립선염환자(慢性前立腺炎患者) 40예(例)에 대(對)한 임상적(臨床的) 고찰(考察))

  • Cho, Chung Sik;Kim, Chul Jung
    • Journal of Haehwa Medicine
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    • v.8 no.2
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    • pp.245-257
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    • 2000
  • A clinical study was done 40 patients of chronic prostatitis who was treated in Dept. of Internal Medicine, Oriental Medicine Hospital, Taejon University, from 1 Mar. 1999 to 31 Oct. 1999. The results were as follows. 1. In distribution of age, 30's and 40's were 57.5% the most, 20's and 60's were 35.0%, 50's was 7.5%. 2. In distribution of past history, the urethritis(45.0%) was the most. 3. In distribution of ocupation, a white-collar worker was 35.0%, a business man was 22.5%, a public servant was 12.5%, etc. 4. Sitting the mean time of day were distributed 5~7 hours, above 7 hours, 3~5 hours, under 3 hours, etc. 5. The resting interval of a long distance drive were distributed 2 hours(35.0%), 3 hours(32.5%), etc. 6. The habit of enduring ejaculation during sexual intercourse was showed 45.0%. 7. The habit of enduring urination was showed 20.0%. 8. Influency of mental stress was showed 90.0%. 9. Ten cases(25.0%) were showed riding horse or riding bicycle. 10. Four cases(10.0%) were showed wearing tight trousers. 11. The habit of put a wallet his hip pocket was showed 57.5%. 12. The most common symptom was distributed the others symp-tom(66.8%) and the voiding symptom(63.3%) more than pain-neuro-logical symptom(37.5%) and symptom related with sexual function (26.6%). 13. In distribution of palpation, lower abdominal pain, lumbar pain, perineal or parascrotal pain were mostly showed right side. Moreover diagnosis of pulsation was weakly showed chi pulse of right. 14. Duration of disease were distributed above 1 year(82.5%), under 1 year(17.5%). Degree of prostatitis was severe showed adove 1 year. 15. The distribution of WBC count of the prostatic secretion, com-paring with before therapy and after therapy, were showed from 5 cases to 0 case in very many/HPF, from 23 cases to 13 cases in many/HPF, from 12 cases to 13 cases in 10~30/HPF, from 0 case to 13 cases in under 10/HPF. 16. Therapeutic improvement of symptom were distributed pain-neurological symptom(94.8%), the others symptom(90.8%), the void-ing symptom(89.6%) and symptom related with sexual function(67.5%). 17. Differentiation of symptoms and signs were distributed dificiency of spleen-lung vital energy, wetness-heat of lower warmer, dificiency of spleen-kidney yang, dificiency of kidney yin, wetness-phlegm, dificiency of vital energy and blood. The prescriptions were Bojungikgitang(44.6%), Yukmijihwangtang(20.7%), Palmijihwangtang(12.0%), etc.

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A Study of Home Care Needs of Patients at Discharge and Effects of Home Care -Centered on Patients Discharged from a Rural General Hospilal- (퇴원환자의 가정간호요구와 가정간호사업의 효과 분석 - 일 종합병원을 중심으로)

  • Choi, Yun Soon;Kim, Dai Hyun;Storey, Margaret;Kim, Cho Ja;Kang, Kyu Sook
    • The Korean Nurse
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    • v.31 no.4
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    • pp.77-99
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    • 1992
  • The study was carried out at W. hospital, an affiliated hospital of Y university, involved a total of 163 patients who were discharged from the hospital between May 1990 und March 199J. Data collection was twice, just prior to discharge and a minimum of three months post discharge. Thirty patients who lived within a hour travel time of the hospital received home care during the three months post discharge. Nursing diagnoses and nursing interventions For these patients were analyzed in this study. The results of the study are summarized as follows : 1. Discharge needs for the subjects of the study were analyzed using Gordon's eleven Functional categories and it was found that 48.3% of the total sample had identified nursing needs. Of these, the needs most frequently identified were in the categories of sexuality, 79.3 %, health perception, 68.2 % self concept, 62.5 %, and sleep and rest 62.5 %. Looking ut j he nursing diagnosis that were made for the 30 patients receiving home care, the following diagnoses were the most frequently given; alteration in sexual pattern 79.3%, alterations in health maintenance, 72.6%, alteration in comfort, 68.0%, depression, 64.0%, noncompliance with diet therapy, 6.3.7%, alteration in self concept, 55.6%, and alteration in sleep pattern, 53%. 2. In looking at the effects of home nursing care as demonstrated by changes in the functional categories over the three month period, it was Found that of the 11 functional categories, the need level for health perception, nutrition, activity and self concept decreased slightly over the three month period. On the average sleep patterns improved, but restfulness was slightly less and bowel elimination patterns improved but satisfaction with urinary elimination was slightly less. On the other hand, role enactment, sexuality, stress management and spirituality decreased slightly. The only results that were statistically significant at the 0.05 level were improvement. in digestion and decrease in pain. No statistically significant changes were found in ability related to ADL, the total ADL Score at discharge was $19.78{\pm}8.234, and after 3 months $19.01{\pm}8.12$. Considering that a majority of the patients were over 60 years of age and that many had brain or spinal cord injuries, the fact that their ADL ability did nor deteriorate after discharge can be interpreted as related to a positive impact by the home health care nurses. Similarly there was a slight be not statistically significant decrease in the quality of life scores between the two lest times(l47.83 at discharge and 113.02 at the three month period). Again, when the chronic nature of thee problems facing these patients is considered this maintenance of quality of life can be interpreted as a positive impact by the home health care nurses. 3. One of the home care nursing activities was diagnosis. For this activity it was found that for nine functional health categories(sexuality and spirituality excepted) there were 20 nursing diagnoses. The most frequent were noncompliance, alteration in skin integrity both actual and potential, and impaired physical mobility in that order. 4. Delivery of home health care by the home health nurses included the following nursing activities; assessment, patient education, demonstration of care activities, counselling, direct care to the patient and referrals. Direct care included changing dressings, bladder irrigations, changing Foley catheters, measurement of residual urine, perineal care, position change, back care, oral hygiene, exercise and massage of motion exercises, cleansing enemas, tracheostomy suctioning and tracheostomy care, care of dentures, applications of heat and other similar nursing activities. In conclusion almost 50% of (he sample indicated a need for continued nursing care at the time of discharge and for the patients in the sample who received home care there was a slight decrease in nursing needs but while the patients had chronic and debilitation problems there was ill decrease in ADL abilities or in quality of life. Further study needs Lo be done La increase the reliability and validity of the tool that was used to measure home health care needs. It is also recommended that study by done using a randomized sampling with a control group to compare patients who receive home care with those who do not.

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