Improved longevity and efficacy of sacral nerve stimulation by simple adjustments at follow‐up
| Autor: | Lilli Lundby, Søren Laurberg, Steen Buntzen, Jakob Duelund-Jakobsen |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Visual analogue scale
faecal incontinence medicine.medical_treatment Longevity Lumbosacral Plexus Electric Stimulation Therapy CONSTIPATION Stimulation THRESHOLD 03 medical and health sciences 0302 clinical medicine Patient satisfaction FECAL INCONTINENCE Interquartile range Sensory threshold medicine Humans Neurostimulation Response rate (survey) NEUROMODULATION DOUBLE-BLIND CROSSOVER business.industry Gastroenterology ELECTRICAL-STIMULATION Functional outcome Treatment Outcome Sacral nerve stimulation 030220 oncology & carcinogenesis Anesthesia Quality of Life sacral nerve stimulation 030211 gastroenterology & hepatology business Fecal Incontinence Follow-Up Studies neurostimulation |
| Zdroj: | Duelund-Jakobsen, J, Buntzen, S, Laurberg, S & Lundby, L 2020, ' Improved longevity and efficacy of sacral nerve stimulation by simple adjustments at follow-up ', Colorectal Disease, vol. 22, no. 3, pp. 310-318 . https://doi.org/10.1111/codi.14874 |
| ISSN: | 1463-1318 1462-8910 |
| Popis: | Aim: Sacral nerve stimulation (SNS) for faecal incontinence (FI) at subsensory amplitudes as low as 50% of the sensory threshold has been found to be effective at 3 months’ follow-up. Furthermore, alternative pacemaker settings may improve functional outcome in patients with suboptimal treatment efficacy. In this work we aim to explore if sub-sensory stimulation as low as 50% of sensory threshold is effective at 1-year follow-up. We also aimed to investigate if 31 Hz (frequency) or 90 µs (pulse width) stimulation improved treatment efficacy in dissatisfied patients. Method: All patients in whom the stimulation was effective in controlling FI (satisfied group) were encouraged to have the stimulation amplitude reduced. Those in whom the device was less effective (dissatisfied group) were offered alternative frequency settings or pulse width (31 Hz or 90 µs). Patients were follow-up after 12 months and evaluated by a visual analogue scale (VAS) for patient satisfaction, the Cleveland Clinic Continence Score (CCCS), Rockwood Faecal Incontinence Quality of Life Scale (QoL) and a bowel habit diary. Results: Two hundred and nineteen patients were contacted, with a response rate of 71% (n = 155). Those who were successfully contacted comprised 110 (71%) patients classed as satisfied and 45 (29%) as dissatisfied. Seventy-five (68%) of the satisfied patients agreed to have their stimulation amplitude reduced. At 1-year follow-up the median amplitude had reduced from 1.5 V [interquartile range (IQR) 0.85–2.0 V] to 0.75 V (IQR 0.45–1.4 V) (P-value |
| Databáze: | OpenAIRE |
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