Outcome of Sacral Nerve Stimulation for Fecal Incontinence at 5 Years

Abstract

On an ITT analysis, 42.6% of patients reported favorable outcomes at 60 months. Patient's age, improvement of urge incontinence during PNE, and sustained efficacy during the first 6 months after implantation are some of the predictors identified.

Clinical Challenges of Fecal Incontinence in the Elderly

“…Maeda et al found that increasing age decreases the odds of a successful outcome with SNS by 4.3 % a year [73]. George et al conducted a study examining the role of SNS in patients 65 years of age and older.…”

“…It is still unclear if SNS would be appropriate for patients with dementia, who are wheelchair bound, or in a nursing home. In addition, SNS is a high maintenance procedure and requires frequent office visits to properly manage issues of efficacy and adverse events [73]. Patients must be able to evaluate their improvement and vocalize their concerns regarding SNS implantation to maintain efficacy.…”

Systematic Review of Surgical Treatments for Fecal Incontinence

“…the frequency of surgical complications (tables 3 and 4 and appendix table 5) ranged from 0% to 32% in radiofrequency anal sphincter remodeling, [48][49][50][51][52][53] 21% to 74% in aCe, 54-57 5% to 27% with sphincteroplasty, 13,37,42-45,58-66 2% to 93% with sns, 13,29,30,36,41,47,[67][68][69][70][71][72][73][74][75][76][77][78][79][80][81][82][83][84][85] 8% to 64% with other surgeries, 33,38,39,86 and 22% to 100% with sphincter replacement. 13,32,46,[87][88][89][90][91][92][93][94][95][96][97][98]…”

“…table 4 and appendix table 5), and 3% to 24%41,47,[67][68][69]71,72,[74][75][76][77][78][79][80][81]85 of patients had the device explanted. aCe, sphincter repair, and sphincter replacement had more severe complications (wound infection, stenosis, bowel obstruction, sepsis, and fistula; appendix table 5).…”

Surgical therapies for fecal incontinence

“…Multiple studies over the last year have reported long-term outcomes, demonstrating that the majority of patients treated with SNS experience lasting improvements in incontinence and QOL with minimal complications at mean follow ups ranging from 3-9 years [22][23][24]. Multiple studies over the last year have reported long-term outcomes, demonstrating that the majority of patients treated with SNS experience lasting improvements in incontinence and QOL with minimal complications at mean follow ups ranging from 3-9 years [22][23][24].…”