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Medium-term results with Sacral Nerve Stimulation for management of faecal incontinence, a single centre experience.

Feretis, Michael and Karandikar, Sharad S and Chapman, Mark (2013) Medium-term results with Sacral Nerve Stimulation for management of faecal incontinence, a single centre experience. Journal of interventional gastroenterology, 3 (3). pp. 82-88. ISSN 2154-1280.

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Official URL: http://www.jigjournal.org/content/3/3/123.abstract

Abstract

OBJECTIVE

Sacral Nerve Stimulation (SNS) is an effective but expensive intervention for management of Faecal Incontinence (FI) offered primarily in tertiary centres. It is estimated that 30%-50% of patients fail to respond to temporary SNS. Aim of this study was to evaluate the value of anorectal investigations in patient selection and also to report the mid-term patient results and SNS related morbidity in a secondary referral centre.

METHOD

38 patients (36 female) with FI were offered temporary SNS between January 2008 - May 2012. 32/38 (84%) proceeded to permanent SNS implantation. Patient baseline demographics, anorectal manometry/electrophysiology and endoanal sonography results at baseline were analysed retrospectively. Patient quality of life and symptomatology post-implantation were evaluated by means of a postal quality of life questionnaire.SNS related morbidity was also assessed.

RESULTS

Median patient age was 62 years (29-74) and baseline Wexner score was 14 (6-19). Patient outcome after temporary stimulation was associated with age and the sensory threshold of urge to defecate. (p<0.05) The rest of baseline demographics and anorectal investigations did not affect the outcome. At a median timepoint of 16 months (3-42) patient quality of life and severity of symptoms had improved significantly compared to baseline. (p<0.05) SNS device explantation and site infection rates were zero.

CONCLUSION

Benefit from SNS is maintained up to 2 years on follow-up. Anorectal investigations have little value in predicting the outcome of temporary SNS phase.

Item Type: Article
Subjects: WJ Urogenital system. Urology
Divisions: Planned IP Care > General Surgery
Related URLs:
Depositing User: Preeti Puligari
Date Deposited: 29 Aug 2014 10:20
Last Modified: 29 Aug 2014 10:20
URI: http://www.repository.heartofengland.nhs.uk/id/eprint/655

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