Predictive factors for successful sacral nerve stimulation in the treatment of faecal incontinence: results of trial stimulation in 200 patients

Gallas, Syrine; Michot, F; Faucheron, J.‐L.; Meurette, G.; Lehur, Paul‐Antoine; Barth, X.; Damon, Henri; Mion, François; Zerbib, Frank; Sielezneff, I.; Ouaïssi, Mehdi; Orsoni, P; Desfourneaux, Véronique; Siproudhis, L.; Mathonnet, Muriel; Ménard, Jean-François; Leroi, Anne‐Marie; Nemo, Club

doi:10.1111/j.1463-1318.2010.02260.x

Cited by 59 publications

(49 citation statements)

References 28 publications

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“…Dynamic graciloplasty is nowadays very rarely proposed in the treatment of fecal incontinence because the technique is complex, expensive and has a high morbidity rate [3]. Despite a certain level of expertise, our results with the artificial bowel sphincter, like other authors have recently shown, are less promising than those previously published in the literature [4].Sacral nerve modulation, first developed for the treatment of urinary dysfunction, is another option that has proved to be effective in the treatment of fecal incontinence in patients with an intact or nearly intact sphincter complex [5]. Some authors have demonstrated that sacral neuromodulation could also be beneficial in patients with sphincter defects, in patients presenting with fecal incontinence following anterior resection and chemoradiation for rectal cancer, and in patients suffering from systemic sclerosis or Crohn's disease.…”

mentioning

confidence: 82%

“…Sacral nerve modulation, first developed for the treatment of urinary dysfunction, is another option that has proved to be effective in the treatment of fecal incontinence in patients with an intact or nearly intact sphincter complex [5]. Some authors have demonstrated that sacral neuromodulation could also be beneficial in patients with sphincter defects, in patients presenting with fecal incontinence following anterior resection and chemoradiation for rectal cancer, and in patients suffering from systemic sclerosis or Crohn's disease.…”

mentioning

confidence: 99%

“…Some authors have demonstrated that sacral neuromodulation could also be beneficial in patients with sphincter defects, in patients presenting with fecal incontinence following anterior resection and chemoradiation for rectal cancer, and in patients suffering from systemic sclerosis or Crohn's disease. After implantation, 41-75 % of patients achieve complete fecal continence and 75-100 % experience improvement in episodes of incontinence [5]. A few studies have also reported efficacy of sacral neuromodulation in patients suffering from double incontinence, the urinary incontinence being due to either urge incontinence (involuntary urine leakage following urgency), stress incontinence (involuntary urine leakage during efforts), or mixed (associating both urge and stress incontinence) [6,7].…”

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Sacral neuromodulation for bowel dysfunction

Faucheron

Martín

2013

Tech Coloproctol

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Bowel dysfunction generally refers to a variety of clinical conditions including fecal incontinence, constipation, and chronic pelvic pain.Fecal incontinence is the uncontrolled loss of stool, either liquid or solid. Its true prevalence in the adult population is unknown, but might be as high as 5 % if based on a Cleveland Clinic score above 5/20 [1]. The resulting handicap is responsible for social isolation and reduced quality of life. First treatment should be dietary measures, medication, and biofeedback physiotherapy. Surgery is indicated when conservative treatment fails. Direct sphincter repair is suggested in the case of limited total sphincter rupture, but results deteriorate over time, with only around 50 % of patients still continent at long-term follow-up. Sphincter substitution is indicated in patients with large sphincter defects or a severely disrupted sphincter and in the case of failure of other surgical treatment. Non-stimulated graciloplasty (the so-called Pickrell's procedure) has been abandoned because of the fatigability of the transposed muscle [2]. Dynamic graciloplasty is nowadays very rarely proposed in the treatment of fecal incontinence because the technique is complex, expensive and has a high morbidity rate [3]. Despite a certain level of expertise, our results with the artificial bowel sphincter, like other authors have recently shown, are less promising than those previously published in the literature [4].Sacral nerve modulation, first developed for the treatment of urinary dysfunction, is another option that has proved to be effective in the treatment of fecal incontinence in patients with an intact or nearly intact sphincter complex [5]. Some authors have demonstrated that sacral neuromodulation could also be beneficial in patients with sphincter defects, in patients presenting with fecal incontinence following anterior resection and chemoradiation for rectal cancer, and in patients suffering from systemic sclerosis or Crohn's disease. After implantation, 41-75 % of patients achieve complete fecal continence and 75-100 % experience improvement in episodes of incontinence [5]. A few studies have also reported efficacy of sacral neuromodulation in patients suffering from double incontinence, the urinary incontinence being due to either urge incontinence (involuntary urine leakage following urgency), stress incontinence (involuntary urine leakage during efforts), or mixed (associating both urge and stress incontinence) [6,7].These functional results are obtained with a reasonable, moderate level of complications [8,9]. We published the number and causes of reoperation from a series of 87 consecutive patients operated on in a single institution. Among these patients, 36 had surgical revision of the device for the following reasons: device-related failure due to infection in 4 (successful reimplant in 4), electrode displacement in 2, electrode breakage in 2 (reimplantation of electrode in 4), and dysfunction owing to impedance increase in the system in 4; adverse stimulation with pa...

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confidence: 82%

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Sacral neuromodulation for bowel dysfunction

Faucheron

Martín

2013

Tech Coloproctol

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“…It has to be mentioned that the therapeutic outcome of SNS is diminished in patients with chronic diarrhea. Only one publication indicates a better therapeutic effect in patients with loose stool consistency [23].…”

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confidence: 99%

Sacral nerve stimulation as a therapy for fecal incontinence

Kahlke

Fürst

Leder³

et al. 2016

coloproctology

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“…Rasmussen et al 17 , reportan una tasa de infección del 5%. En el multicéntrico francés 24 , la tasa descrita, es muy inferior, 1,5%, misma cifra comunicada por Michelsen et al 21 . Tjandra et al 25 , no presentaron ninguna infección, sobre 60 pacientes.…”

Section: Fase De Implantación Del Generador Definitivounclassified

Complicaciones durante la neuromodulación de raíces sacras en el tratamiento de la incontinencia fecal grave

Arroyo

et al. 2013

Rev Chil Cir

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Complications during sacral nerve stimulation in the treatment of severe fecal incontinence Objective: To evaluate the complications of sacral nerve stimulation for the treatment of fecal incontinence. Background: Sacral nerve stimulation is considered to be nowadays an effective treatment for fecal incontinence in selected patients. Many authors have reported excellent results and indication for his use have increased. Nevertheless, even being a simple technique, not it exempts this from complications. Methods: Fifty-two patients with severe faecal incontinence, treated with sacral nerve stimulation between January 2002 and December 2010, were analysed. All adverse events during follow-up were recorded. Results: There was not surgical complication during peripheral neural evaluation test. In our series, with an average follow-up to 55.52 ± 31.84 months (range: 12-121), we had a rate of adverse effects of 14%, infection of surgical wound in two patients, break of electrode in two patients and the presence of pain in the place of the implant, with episodes of extremity pain and paresthesias in low members in 3 patients. Conclusions: Sacral nerve stimulation in severe fecal incontinence is a safe treatment, with a low index of complications.Key words: Sacral nerve stimulation, fecal incontinence, complications, adverse effects. ResumenObjetivo: Evaluar las complicaciones de la neuromodulación de raíces sacras en el tratamiento de la incontinencia fecal. Introducción: La neuromodulación de raíces sacras ha sido descrita como un tratamiento quirúrgico eficaz en pacientes con incontinencia fecal grave. Muchos autores han comunicado excelentes resultados y las indicaciones en su uso han aumentado. Sin embargo, a pesar de ser una técnica quirúrgica sencilla, no está exenta de complicaciones. Material y Método: 52 pacientes con incontinencia fecal grave, tratados mediante neuromodulación de raíces sacras entre enero de 2002 y diciembre de 2010, fueron anali-

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Predictive factors for successful sacral nerve stimulation in the treatment of faecal incontinence: results of trial stimulation in 200 patients

Abstract: Stool consistency and low stimulation intensity have been identified as predictive factors for the short-term outcome of SNS.

Cited by 59 publications

References 28 publications

Sacral neuromodulation for bowel dysfunction

Sacral neuromodulation for bowel dysfunction

Sacral nerve stimulation as a therapy for fecal incontinence

Complicaciones durante la neuromodulación de raíces sacras en el tratamiento de la incontinencia fecal grave

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