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.
【저자키워드】 Pain, steroid, herpes zoster, voiding dysfunction, caudal block, sacral region,