The use of surgical sympathectomy in the treatment of chronic.pdfVIP

British Journal of Urology (1997), 80, 6–10 The use of surgical sympathectomy in the treatment of chronic renal pain B. T. A NDR EW S, N .F. J ONES* and N. L. BRO WSE Departments of Surgery and *Renal Medicine, St Thomas’ Hospital, London, UK Objective To assess the ecacy of renal sympathetic recurrent pain underwent a total of 10 re-explorations denervation in the treatment of chronic renal pain. of the renal pedicle, stripping it of all nerve fibres and Patients and methods In a 10-year period, 21 patients areolar tissue. Three of these re-explorations produced suering from chronic renal pain underwent 27 renal complete pain relief to date (median follow-up 40 denervation operations, six of which were bilateral. months). The median pain-free interval of the other The cause of pain was the loin pain haematuria seven re-explorations in six patients was 19 months. syndrome in 18 patients. Conclusion Renal denervation cures severe intractable Results Four operations resulted in complete pain relief to pain in about 25% of patients. Recurrence of pain date (median follow-up 53.5 months). Pain relief after could be prevented in more patients if there was a the other 23 operations in 18 patients lasted a median way of preventing re-innervation. of 6 months. Assuming that recurrent pain was due to Keywords Loin pain haematuria syndrome, renal dener- neuronal regeneration, nine of the 18 patients with vation, sympathectomy 8 years (94 months, range 28–140). Two patients had Introduction