Programming InterStim™ for faecal incontinence

Abstract

In our patients the 'ideal' programme was not the programme used most frequently, nor for the longest duration. The theoretical migration of the tined lead inwards with time is upheld by our results. Patients who feel the sensation of SNS perianally have lower symptom scores than those who do not and who require re-programming.

The role of reprogramming in sacral nerve modulation for faecal incontinence

“…The parameters adjusted in our centre during stimulation were frequency (Hz), electrode polarity and voltage (V). For maximal symptomatic relief, it is thought that patients should feel the stimulation in the perineal region [8]. In our centre, initial programming was based on the principle of perineal sensation at the lowest possible voltage.…”

Sacral nerve stimulation for faecal incontinence and constipation: a European consensus statement

“…SNS is a form of maintenance therapy. Reprogramming and/or revisional surgery may be required during the course of treatment, including removal of the device as a result of complications .…”

Suboptimal outcome following sacral nerve stimulation for faecal incontinence

“…During the course of treatment some patients require frequent changes of the stimulation programme to optimize the therapy, and on occasion complications associated with the treatment require surgical intervention. However, only a limited number of studies have investigated the amount of clinical input required to maintain efficacy7, 8. In addition, the incidence of suboptimal therapeutic responses and treatment‐related adverse events, and their effect on medium‐ to long‐term treatment outcome, have not been examined thoroughly.…”