Outcome of Sacral Nerve Stimulation for Fecal Incontinence in Patients Refractory to Percutaneous Tibial Nerve Stimulation

Hotouras, Alexander; Murphy, Jamie; Thin, Noel N.; Allison, Marion; Horrocks, Emma J; Williams, Norman S.; Knowles, Charles H.; Chan, Christopher L.

doi:10.1097/dcr.0b013e31827f0697

Cited by 26 publications

(25 citation statements)

References 22 publications

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“…Within-group effect estimates were in general larger for SNS, based on analysis of all patients embarking on treatment, with greater benefits still in patients who progressed to permanent implantation. This finding is in keeping with non-randomized comparisons of SNS and PTNS 36 . Although the present data are insufficient to advise on whether PTNS should be offered as an alternative to SNS, based on efficacy, the study does indicate that both treatments are highly acceptable to patients, with some expressing a preference for one treatment over the other.…”

Section: Discussionsupporting

confidence: 88%

Randomized clinical trial of sacral versus percutaneous tibial nerve stimulation in patients with faecal incontinence

Thin¹,

Taylor

Bremner

et al. 2015

British Journal of Surgery

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Section: Discussionsupporting

confidence: 88%

Randomized clinical trial of sacral versus percutaneous tibial nerve stimulation in patients with faecal incontinence

Thin¹,

Taylor

Bremner

et al. 2015

British Journal of Surgery

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“…7,8 The short-and mid-term success of SNM in patients with FI has been demonstrated in several studies. [9][10][11] Recently, studies with long-term follow-up have shown a lasting effect. [12][13][14] Data regarding constipation are rare, particularly data with a long-term followup.…”

Section: Introductionmentioning

confidence: 99%

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

Widmann

Galata

Warschkow

et al. 2019

J Neurogastroenterol Motil

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Background/AimsThe aim of this study was to evaluate the sustainability of sacral neuromodulation (SNM) success in patients with fecal incontinence (FI) and/or constipation.MethodsThis is a retrospective analysis of a prospective database of patients who received SNM therapy for FI and/or constipation between 2006 and 2015. Success rates, complications and reintervention rates were assessed after up to 10 years of follow-up.ResultsElectrodes for test stimulation were implanted in 101 patients, of whom 79 (78.2%) received permanent stimulation. The mean follow-up was 4.4 ± 3.0 years. At the end of follow-up, 57 patients (72.2%) were still receiving SNM. The 5-year success rate for FI and isolated constipation was 88.2% (95% confidence interval [CI], 80.1–97.0%) and 31.2% (95% CI, 10.2–95.5%), respectively (P < 0.001). In patients with FI, involuntary evacuations per week decreased > 50% in 76.1% of patients (95% CI, 67.6–86.2%) after 5 years. A lead position at S3 was associated with an improved outcome (P = 0.04). Battery exchange was necessary in 23 patients (29.1%), with a median battery life of 6.2 years. Reinterventions due to complications were necessary in 24 patients (30.4%). For these patients, the 5-year success rate was 89.0% (95% CI, 75.3–100.0%) compared to 78.4% (95% CI, 67.2–91.4%) for patients without reintervention.ConclusionsSNM offers an effective sustainable treatment for FI. For constipation, lasting success of SNM is limited and is thus not recommended. Reinterventions are necessary but do not impede treatment success.

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“…In addition, the posterior tibial nerve is being increasingly utilized as a nerve stimulation site because of the added advantage of percutaneous and transcutaneous therapy, rather than invasive lead placement. Hotouras et al [31] observed that 68.4% of their patients who did not have improvement in symptoms with PTNS (n ¼ 20) reported a decrease in incontinence after SNS. To elucidate the optimal route for PTNS, George et al [30 && ] conducted a randomized controlled trial comparing percutaneous PTNS (n ¼ 11), transcutaneous PTNS (n ¼ 11), and sham transcutaneous PTNS (n ¼ 8).…”

Section: Nerve Stimulation Techniquesmentioning

confidence: 96%

Surgical therapies for fecal incontinence

Nandivada

Nagle²

2014

Current Opinion in Gastroenterology

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Outcome of Sacral Nerve Stimulation for Fecal Incontinence in Patients Refractory to Percutaneous Tibial Nerve Stimulation

Abstract: Sacral nerve stimulation appears to be an effective treatment for patients who do not gain an adequate therapeutic benefit from percutaneous tibial nerve stimulation and, thus, should be routinely considered for this patient cohort.

Cited by 26 publications

References 22 publications

Randomized clinical trial of sacral versus percutaneous tibial nerve stimulation in patients with faecal incontinence

Randomized clinical trial of sacral versus percutaneous tibial nerve stimulation in patients with faecal incontinence

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

Surgical therapies for fecal incontinence

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