Sacral neuromodulation in patients with fecal incontinence: a single-center study

Autor: Cees H C Dejong, S. M. P. Koch, Wim G. van Gemert, Cor G. M. I. Baeten, Ö Uludag
Přispěvatelé: Algemene Heelkunde, RS: NUTRIM School of Nutrition and Translational Research in Metabolism
Jazyk: angličtina
Rok vydání: 2004
Předmět:
Zdroj: Diseases of the Colon & Rectum, 47(8), 1350-1357. LIPPINCOTT WILLIAMS & WILKINS
ISSN: 1530-0358
0012-3706
DOI: 10.1007/s10350-004-0589-9
Popis: Sacral neuromodulation in patients with fecal incontinence: a single-center study.Uludag O, Koch SM, van Gemert WG, Dejong CH, Baeten CG.Department of Colorectal Surgery, University Hospital Maastricht, Maastricht, The Netherlands.PURPOSE: Fecal incontinence is a psychologically devastating and socially incapacitating condition. Conventional treatment is likely to improve continence in many patients; however, there remains a group with persisting symptoms who are not amenable for a simple surgical repair. We evaluated the effect of sacral neuromodulation in patients with structurally intact sphincters after failure of conventional treatment. METHODS: Patients aged 18 to 75 years were evaluated. Incontinence was defined as involuntary loss of stool at least once per week, which was objectified by completion of a three-week bowel-habits diary during ambulatory electrode stimulation at the S3 or S4 foramen. Patients were qualified for permanent stimulation when showing a reduction of at least 50 percent in incontinence episodes or days. RESULTS: Seventy-five patients (66 females; mean age, 52 (range, 26-75) years) were treated. Three patients had partial spinal cord injury, two patients a previous low-anterior resection, and nine patients had a previous sphincter repair. Evaluation after trial screening showed that 62 patients (83 percent) had improved continence. Median incontinence episodes per week decreased from 7.5 to 0.67 (P < 0.01), median incontinence days per week from 4 to 0.5 (P < 0.01). The symptomatic response stayed unchanged after implantation of a permanent electrode and pacemaker in 50 patients. After a median follow-up of 12 months, this effect could be sustained in 48 patients. Anal manometry during stimulation showed no increase of sphincter pressures. CONCLUSIONS: Sacral neuromodulation is a feasible treatment option for fecal incontinence in patients with structurally intact sphincters.
Databáze: OpenAIRE
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