Exhausted implanted pulse generator in sacral nerve stimulation for faecal incontinence: What next in daily practice for patients?

Abstract

In this study, the implanted pulse generator observed median lifespan was 9 years. After exhaustion, generators were safely and efficiently replaced. The study also gives insight into long-term needs and costs of sacral nerve stimulation (SNS) therapy.

Long-Term Outcome Following Implanted Pulse Generator Change in Patients Treated With Sacral Nerve Modulation for Fecal Incontinence

“…The present study is in continuity with what we have previously published on IPG replacement (2). Based on our own practice, we showed that IPG replacement is a safe procedure with a minimal risk of complication.…”

“…It has been shown that implanted pulse generators (IPG) used for SNM had an observed median lifespan of 9 years (95% confidence interval [CI] = 8-9.2). Interstim and Interstim II 25th percentile lifespan was 7.2 (CI = 6.4-8.3) and 5 (CI = 4-not reached) years, respectively (2). After exhaustion, IPG were safely replaced and efficiency was maintained in the short term with similar mean Cleveland Clinic Fecal Incontinence Score (CCF-FI) and Fecal Incontinence Quality of Life (FIQL) scores collected 3 months before and 6 months after IPG replacement (3,4).…”

Success and Complication Rates After Sacral Neuromodulation for Fecal Incontinence and Constipation: A Single-center Follow-up Study

“…By extrapolation, a median survival of approximately 6.5 years might be expected. 41 For the InterStim I stimulator, a median lifespan of 8.8 years was found. Otherwise, relatively little data are available on battery life.…”

“…In accordance with the previously mentioned study, this trial showed that SNM therapy is still successful after replacing the IPG. 41 It is challenging to evaluate adverse events and reinterventions, since most events occur several years after implantation. Most studies have focused on the efficacy of SNM therapy, and many did not describe adverse events in detail.…”

New Technologies and Applications in Sacral Neuromodulation: An Update

“…A second issue relates to the requirement for battery (IPG) changes. The battery life of rechargeable devices has been estimated as 15 years compared to the longevity of the current InterStim II (IPG), which in clinical practice is about 5-7 years [11][12][13]. As a result of the claimed longer battery life of a rechargeable IPG, it has therefore been suggested that this therapy is associated with a reduced need for reoperation [14].…”