Destination Medicine Times Five
Five women from five states traveled a collective 5,742 miles to Beaumont Health System's Women's Urology Center seeking relief from years of urologic symptoms including severe pelvic pain, urinary frequency and urgency.
All five came to see Kenneth Peters, MD, Urology chief and director of Beaumont's Women's Urology Center, on the same day - Sept. 24 - for an outpatient procedure called pudendal neuromodulation that is attracting people from across the country to Michigan.
Dr. Peters pioneered this procedure where a tiny electrode is placed at the pudendal nerve in the pelvis that branches the second, third and fourth sacral nerves. An electrical pulse generator similar to a heart pacemaker connected to the electrode is implanted in the patient's upper buttock. The device emits a low level pulse that stimulates the pudendal nerve, sending signals to the brain to override abnormal signals causing pelvic pain, urinary or bowel issues.
"We developed pudendal nerve neuromodulation at Beaumont through research studies starting in 2004," says Dr. Peters. "In the past year, we've had patients from 26 states and four countries come here for the treatment, but it's unusual to have five patients from five states here at the same time."
The five patients came from California, Nebraska, New York, Wisconsin and Montana ranging in age from 18 to 65 with symptoms of pelvic floor dysfunction – including debilitating pelvic pain and/or urinary frequency and urgency. It was the first visit to the Detroit metro area for four of them.
On Sept. 25, Dr. Peters performed procedures placing electrodes at the pudendal nerve in all five patients. The electrodes were connected to test boxes worn outside their bodies so that they could return home to "test drive" the treatment for two weeks.
Although not a cure, the procedure is successful about 85 percent of the time in achieving at least a 50 percent improvement in symptoms. Some get an 80 to 90 percent improvement. Dr. Peters has performed the procedure on about 200 patients, more than anyone else in the world.
"We think that neuromodulation works by affecting central processing in the brain," says Dr. Peters. "In patients with voiding dysfunction or pelvic pain, there is something wrong in the communication. The wrong signals are being sent through the nerves to those organs which leads to the underlying problem."
The five women returned to Beaumont on Oct. 7 for re-evaluation and permanent implantation of the electrical pulse generators. All five women reported improvement in their symptoms.
Even for those whose symptoms do not improve, Dr. Peters says, "Don't give up hope. We think out of the box and are very involved in research. We are always working on something new."
Dr. Peters' research on pudendal neuromodulation has been published in urology journals. A "Hands-on Neuromodulation" symposium sponsored by Beaumont Sept. 20-21 attracted 70 physicians and nurses from around the country – and one physician from Colombia – to learn about treatments for voiding disorders, pelvic pain and pelvic floor dysfunction.
Millions of women suffer from bladder dysfunction, including about 30 million in the US. One in seven women have chronic pelvic pain.
Many of them see multiple doctors and are treated with high-dose pain medications, pain injections and sacral nerve neuromodulation, searching for relief.
"The women we see have suffered a long time, affecting their quality of life and relationships with their kids and spouses," says Dr. Peters. "They are told they have to learn to live with it. I tell them they are going to be better. It really is amazing when you make somebody better, who no one else has been able to help. As a physician, nothing feels better than that."
Beaumont's Women's Urology Center, opened in March 2010, offers a multidisciplinary, personal approach to urologic, sexual function and pelvic pain conditions in women. Services of the center include: clinical evaluation, testing and treatment; minimally invasive procedures; specialized physical therapy; psychological support; clinical massage, guided imagery and other integrative medicine treatments.
The first of its kind in the Midwest and one of a handful in the U.S., the center was made possible through a $5 million gift from Susan E. Cooper of Birmingham, a long-time member of the Beaumont Health System and the Beaumont Foundation Boards.
To schedule a consultation at the Women's Urology Center, located at Beaumont Hospital in Royal Oak, Mich., call 248-898-0898.