Effectiveness of SSRI for postsurgical chronic pain of mid-urethral sling procedure; A case report

DOI
  • Kitajima Yuka
    Osaka General Medical Center, Department of Obstetrics and Gynecology
  • Takemura Masahiko
    Osaka General Medical Center, Department of Obstetrics and Gynecology
  • Funatsu Eriko
    Osaka General Medical Center, Department of Obstetrics and Gynecology
  • Yamamoto Kana
    Osaka General Medical Center, Department of Obstetrics and Gynecology
  • Kitano Saki
    Osaka General Medical Center, Department of Obstetrics and Gynecology
  • Unno Hikari
    Osaka General Medical Center, Department of Obstetrics and Gynecology
  • Kubota Satoshi
    Osaka General Medical Center, Department of Obstetrics and Gynecology
  • Tanaka Hiroko
    Osaka General Medical Center, Department of Obstetrics and Gynecology
  • Shimazu Yukiko
    Osaka General Medical Center, Department of Obstetrics and Gynecology
  • Goa Satoko
    Osaka General Medical Center, Department of Obstetrics and Gynecology
  • Taguchi Takako
    Osaka General Medical Center, Department of Obstetrics and Gynecology
  • Wakimoto Tetsu
    Osaka General Medical Center, Department of Obstetrics and Gynecology
  • Sumikura Tomoko
    Osaka General Medical Center, Department of Obstetrics and Gynecology
  • Iwamiya Tadashi
    Osaka General Medical Center, Department of Obstetrics and Gynecology

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Other Title
  • 経閉鎖孔式中部尿道スリング（TOT）手術後の術後遷延性疼痛（CPSP）に対して 選択的セロトニン再取り込み阻害剤（SSRI）が著効した一例

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<p>A 67-year-old woman with stress urinary incontinence and third-stage rectocele underwent trans obturator tape surgery and perineoplasty. She complained of strong vulvar pain without incentives 21 days after surgery, and the pain continued thereafter. No resistance or tenderness was noted at the puncture site or along the tape route, and we did not observe an inflammatory reaction. We administered drug therapy as we believed that the pain was likely related to the mesh graft; however, treatment with nonsteroidal anti-inflammatory drugs, and pregabalin had no effect. Therefore, we decided to perform an operation to remove the mesh. Simultaneously, the patient started taking escitalopram oxalic acid, and her pain quickly disappeared. An existing guideline recommends the use of a serotonin noradrenaline reuptake inhibitor for chronic postsurgical pain, including pain after mesh graft surgery. In this case, a selective serotonin reuptake inhibitor was effective.</p>

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