Loin Pain Hematuria Syndrome (LPHS) is a rare condition characterized by cryptogenic debilitating flank pain and microscopic or macroscopic hematuria.
Pathophysiology
The pathophysiology of LPHS remains poorly understood and diagnosis is made largely by exclusion of alternate pathology.
Treatment
Management strategies can vary widely and include chronic opioid medication and a variety of invasive procedures including regional nerve blocks, transcutaneous electrical nerve stimulation, local capsaicin infusion, and surgical renal denervation. Neuromodulation may provide a new paradigm of treatment for LPHS, potentially sparing patients from long term complications of opiate therapy and invasive surgery.
A report of Richter et al. from the Department of Neurosurgery, Allegheny General Hospital, demonstrates the first case of successful symptomatic management of LPHS using spinal cord stimulation1).
1) Richter B, Bergman J, Pierre J, Tomycz ND. Spinal Cord Stimulation for LoinPain Hematuria Syndrome: Case Report. Pain Pract. 2018 Dec 16. doi:10.1111/papr.12755. [Epub ahead of print] PubMed PMID: 30554461.