 Minimally invasive & reversible treatment option for chronic pain  Neuropathic pain  Few previous case reports in severe abdominal / pelvic visceral pain  No previous report in chronic renal pain

 38 y/o Female with 15 year history of Rt sided flank pain & frequent UTIs  Clinical diagnosis of Congenital UPJO was made  No response to different interventions including stenting  Failed Conservative treatment  Minimal relief with opioids  Was finally referred to the pain clinic by Urology prior to undergoing robotic nephrectomy

 Pain Level: 8/10 on VAS; 10/10 on flare-up episodes  Moderate pain on deep palpation of Abdomen and Rt flank region

 Sympathetic Plexus Block:  Celiac Block: No benefit  Superior Hypogastric block: Benefit but of limited duration  Spinal Cord Stimulation

A single octad lead with the tip at the level of the mid 7 vertebral body, slightly right on center.

 During 7-day Trial period:  85% pain relief  Did not take any oral pain medications  Improved overall function, sleep & mood  Permanent implantation performed 4 wks later  9 months later: only use OTC pain medications PRN

 Gate Control theory (mainly somatic pain)  Suppress nociceptive viscero-motor reflex  Increase in local visceral blood flow

 Patients with persistent chronic renal pain:  Conservative modalities should be utilized initially  More Interventional procedures as autonomic plexus block may be considered  If all failed:  SCS may provide a viable long-term option