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Caudal block with steroid in the treatment of acute voiding dysfunction and pain caused by sacral herpes zoster: A case report.
Medicine (Baltimore). 2020 Jun 19; 99(25):e20680.M

Abstract

RATIONALE

Herpes zoster (HZ) involving sacral dermatome is very rare, which can sometimes cause voiding dysfunction.

PATIENT CONCERNS

A 52-year-old man presented with acute pain and voiding dysfunction, following HZ in his right sacral dermatomes.

DIAGNOSES

Twenty two days before presentation HZ occurred and 9 days after the onset of the HZ, he had trouble with starting urination and weak urine stream which was managed with tamsulosin 0.4 mg orally once a day and intermittent urinary catheterization. He was treated with 150 mg of pregabalin 2 times a day, tramadol 50 mg 2 times, and acetaminophen 600 mg 2 times a day. However, his pain intensity was 5 on the numerical analogue scale (NRS) from 0 (no pain) to 10 (worst pain imaginable).

INTERVENTIONS

Fluoroscopy guided caudal block was performed with a mixture of 0.5% lidocaine 10 mL and triamcinolone 40 mg.

OUTCOMES

One day after the procedure, the pain decreased to 1 on the NRS score. In addition, voiding difficulty greatly improved. Three days after the intervention, the patient reported complete resolution of pain and voiding dysfunction. He currently remains symptom free at a 3-month follow-up.

LESSONS

A caudal block with steroid can be an effective option for treatment of acute voiding dysfunction and pain following sacral HZ.

Authors+Show Affiliations

Department of Anesthesiology and Pain Medicine, School of Dentistry, Kyungpook National University, Daegu, Republic of Korea. Department of Anesthesiology and Pain medicine, Kyungpook National University Hospital, Daegu, Republic of Korea.Department of Anesthesiology and Pain medicine, Kyungpook National University Hospital, Daegu, Republic of Korea.

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

32569199

Citation

Jeon, Younghoon, and Yehun Jin. "Caudal Block With Steroid in the Treatment of Acute Voiding Dysfunction and Pain Caused By Sacral Herpes Zoster: a Case Report." Medicine, vol. 99, no. 25, 2020, pp. e20680.
Jeon Y, Jin Y. Caudal block with steroid in the treatment of acute voiding dysfunction and pain caused by sacral herpes zoster: A case report. Medicine (Baltimore). 2020;99(25):e20680.
Jeon, Y., & Jin, Y. (2020). Caudal block with steroid in the treatment of acute voiding dysfunction and pain caused by sacral herpes zoster: A case report. Medicine, 99(25), e20680. https://doi.org/10.1097/MD.0000000000020680
Jeon Y, Jin Y. Caudal Block With Steroid in the Treatment of Acute Voiding Dysfunction and Pain Caused By Sacral Herpes Zoster: a Case Report. Medicine (Baltimore). 2020 Jun 19;99(25):e20680. PubMed PMID: 32569199.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Caudal block with steroid in the treatment of acute voiding dysfunction and pain caused by sacral herpes zoster: A case report. AU - Jeon,Younghoon, AU - Jin,Yehun, PY - 2020/6/23/entrez PY - 2020/6/23/pubmed PY - 2020/7/7/medline SP - e20680 EP - e20680 JF - Medicine JO - Medicine (Baltimore) VL - 99 IS - 25 N2 - RATIONALE: Herpes zoster (HZ) involving sacral dermatome is very rare, which can sometimes cause voiding dysfunction. PATIENT CONCERNS: A 52-year-old man presented with acute pain and voiding dysfunction, following HZ in his right sacral dermatomes. DIAGNOSES: Twenty two days before presentation HZ occurred and 9 days after the onset of the HZ, he had trouble with starting urination and weak urine stream which was managed with tamsulosin 0.4 mg orally once a day and intermittent urinary catheterization. He was treated with 150 mg of pregabalin 2 times a day, tramadol 50 mg 2 times, and acetaminophen 600 mg 2 times a day. However, his pain intensity was 5 on the numerical analogue scale (NRS) from 0 (no pain) to 10 (worst pain imaginable). INTERVENTIONS: Fluoroscopy guided caudal block was performed with a mixture of 0.5% lidocaine 10 mL and triamcinolone 40 mg. OUTCOMES: One day after the procedure, the pain decreased to 1 on the NRS score. In addition, voiding difficulty greatly improved. Three days after the intervention, the patient reported complete resolution of pain and voiding dysfunction. He currently remains symptom free at a 3-month follow-up. LESSONS: A caudal block with steroid can be an effective option for treatment of acute voiding dysfunction and pain following sacral HZ. SN - 1536-5964 UR - https://www.unboundmedicine.com/medline/citation/32569199/Caudal_block_with_steroid_in_the_treatment_of_acute_voiding_dysfunction_and_pain_caused_by_sacral_herpes_zoster:_A_case_report L2 - https://doi.org/10.1097/MD.0000000000020680 DB - PRIME DP - Unbound Medicine ER -