Long-term Outcomes of Sacral Nerve Stimulation on the Treatment of Fecal Incontinence: A Systematic Review.

Autor: Eggers E; Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Cooper University Healthcare, Camden, NJ, USA. Electronic address: ericalynnee@gmail.com., Crouss T; Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Cooper University Healthcare, Camden, NJ, USA., Beausang J; Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Cooper University Healthcare, Camden, NJ, USA., Smith D; Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Cooper University Healthcare, Camden, NJ, USA., Spector S; Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Cooper University Healthcare, Camden, NJ, USA., Saracco B; Cooper Medical School of Rowan University, Camden, NJ, USA., Adams A; Cooper Medical School of Rowan University, Camden, NJ, USA., Dickinson T; Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Cooper University Healthcare, Camden, NJ, USA., Lipetskaia L; Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Cooper University Healthcare, Camden, NJ, USA.
Jazyk: angličtina
Zdroj: Neuromodulation : journal of the International Neuromodulation Society [Neuromodulation] 2024 Aug 17. Date of Electronic Publication: 2024 Aug 17.
DOI: 10.1016/j.neurom.2024.06.504
Abstrakt: Introduction: Sacral nerve stimulation (SNS) has now been used as a treatment for fecal incontinence (FI) for >20 years. The aim of this systematic review was to determine the long-term efficacy of SNS on the treatment of FI.
Materials and Methods: A comprehensive search of the MEDLINE, Embase, and Cochrane Central data bases was performed to find publications, excluding case reports, reporting outcomes of SNS treatment for FI in adults with ≥36 months of follow-up. Bias was assessed using the Risk of Bias in Non-randomized Studies-of Interventions tool. Data were summarized per reported FI-related outcomes for symptom severity and quality of life.
Results: In total, 3326 publications were identified, and 36 studies containing 3770 subjects were included. All studies had a serious risk of bias. Success was variably defined by each publication and ranged from 59.4% to 87.5% for per-protocol analyses and 20.9% to 87.5% for intention-to-treat analyses. All studies reporting bowel diary data, St Mark's scores, and Cleveland Clinic Incontinence Scores indicated significant improvement with SNS treatment in the long term. Studies that evaluated quality-of-life outcomes also all showed improvements in quality of life as measured by the Fecal Incontinence Quality of Life Scale. The aggregate revision rate was 35.2%, and the explantation rate was 19.7%.
Conclusions: Improvements in objective and subjective outcomes at ≥36 months support using SNS for the long-term treatment of FI. Interpretation of these data is limited by a lack of comparative trials and heterogeneity of the included studies.
Competing Interests: Conflict of Interest The authors reported no conflict of interest.
(Copyright © 2024 International Neuromodulation Society. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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