Background: Chronic renal pain secondary to uretero-pelvic junction obstruction (UPJO) is common
but remains poorly understood. Patients with UPJO experience frequent infections, renal calculi
and pain. Management options for patients with this condition are traditionally limited to surgical
interventions to eliminate the obstruction.
Spinal Cord Stimulation (SCS) has gained widespread popularity for the treatment of numerous
conditions from complex regional pain syndrome to failed back syndrome. With continued success,
the possible use of SCS has steadily increased.
Although a significant number of patients with severe chronic renal pain will transiently respond to
analgesics and physical interventions such as autonomic sympathetic blocks, substantial long-term
pain relief is usually lacking. SCS therefore might be a welcome addition to the treatment of moderate
to severe chronic renal pain. .
Objective: This article presents a case of using spinal cord stimulation in the management of chronic
renal pain secondary to Uretero-pelvic junction obstruction.
Design: Case report
Setting: Academic University Pain Management Center
Methods: A 38-year old female presented with a 15-year history of persistent right sided flank pain
secondary to congenital uretero-pelvic junction obstruction. After failing to respond adequately to
stenting, medications and nerve blocks, a trial of spinal cord stimulation and subsequent permanent
implantation of a spinal cord stimulator (SCS) were performed.
Results: The patient reported significant improvement in pain, overall functioning and no
consumption of opioids during the SCS trial and following system implant.
Limitations: A case report.
Conclusion: Spinal cord stimulation might be an option in the management of chronic renal pain
secondary to Uretero-pelvic junction obstruction.
Key words: spinal cord stimulation, renal pain, uretero-pelvic jnction obstruction, visceral pain, flank
pain, pelvic pain