Sacral nerve stimulation in the treatment of fecal incontinence – the experience of a pelvic floor center: Short-term results

Iachetta, Roberto Paolo; Cola, Alessandra; Villani, Roberto Dino

doi:10.4161/jig.23745

Cited by 11 publications

(7 citation statements)

References 10 publications

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“…The rate of surgical site infection has been reported to be between 1% and 23%. [3][4][5][6][7] Length of time between stages 1 and 2 has not been shown to be predictive of risk of infection. 8 Use of gentamicin-impregnated collagen has been described as a potential method to reduce surgical site infections.…”

mentioning

confidence: 95%

Risk Factors for Surgical Site Infection in Patients Undergoing Sacral Nerve Modulation Therapy

Brueseke

Livingston

Warda

et al. 2015

Female Pelvic Medicine &Amp; Reconstructive Surgery

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Surgical site infection is a significant risk of SNM surgery, although our infection rate is lower than previously reported. Chlorhexidine washing appears to reduce the risk of infection in this population. Because the majority of infections requiring explantation were methicillin-resistant S. aureus positive, prophylactic treatment for this organism should be considered as an additional strategy to reduce infection. Body mass index and immunosuppression appear to be independent risk factors for infection.

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mentioning

confidence: 95%

Risk Factors for Surgical Site Infection in Patients Undergoing Sacral Nerve Modulation Therapy

Brueseke

Livingston

Warda

et al. 2015

Female Pelvic Medicine &Amp; Reconstructive Surgery

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“…VNS was previously shown to suppress colonic inflammation in similar animal models as in this study and to be feasible and effective in treating patients with Crohn's disease . SNS has been reported for the treatment of fecal incontinent, slow transit constipation, and diarrhea‐predominant irritable bowel syndrome and also reported to be useful in improving the symptoms of interstitial cystitis (IC) in human being and in reinforcing rectal epithelial barrier in a porcine model . To the best of our knowledge, there has not been published studies except a clinical case report investigating the anti‐inflammation effect and mechanisms of SNS.…”

Section: Discussionmentioning

confidence: 62%

“…13,15 VNS was previously shown to suppress colonic inflammation in similar animal models as in this study and to be feasible and effective in treating patients with Crohn's disease. 37 SNS has been reported for the treatment of fecal incontinent, slow transit constipation, and diarrhea-predominant irritable bowel syndrome 38 and also reported to be useful in improving the symptoms of interstitial cystitis (IC) in human being [39][40][41] and in reinforcing rectal epithelial barrier in a porcine model. 42 To the best of our knowledge, there has not been published studies except a clinical case Based on the cholinergic anti-inflammatory pathway and the innervation of pelvic splanchnic nerve from the sacral nerve, we hypothesized an anti-inflammatory effect of SNS that might be more potent than VNS for distal colon inflammation since the distal colon is believed to be innervated more densely with sacral nerve than vagus nerve.…”

Section: Effects Of Sns On Intestinal Inflammatory In Dss-treated Ratsmentioning

confidence: 99%

Sacral nerve stimulation improves colonic inflammation mediated by autonomic‐inflammatory cytokine mechanism in rats

Guo¹,

Jin²,

Shi³

et al. 2019

Neurogastroenterology Motil

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Background Vagal nerve stimulation (VNS) was reported to have a therapeutic potential for inflammatory bowel disease (IBD). This study was designed to determine effects and mechanisms of SNS on colonic inflammation of in rodent models of IBD and compare the difference among SNS, VNS, and SNS plus VNS. Methods Intestinal inflammation in rats was induced by intrarectal administration of TNBS (2,4,6‐Trinitrobenzenesulfonic acid) on the first day. Five days after intrarectal TNBS, the rats were treated with sham‐VNS, VNS, Sham‐SNS, SNS, and SNS + VNS for 10 days. In another experiment, after 10 days of 4% DSS (dextran sodium sulfate) in drinking water, rats were treated with 10‐day sham‐SNS and SNS. Various inflammatory responses were assessed; mechanisms involving autonomic functions and inflammatory cytokines were investigated. Key Results (a) VNS, SNS, and VNS + SNS significantly and equally decreased the disease activity index and macroscopic scores, and normalized colon length; (b) IL‐10 was decreased by TNBS but increased with SNS, VNS, and SNS + VNS; pro‐inflammatory cytokines, IL‐6, IL‐17A, MCP‐1 and TNF‐α, were increased by TNBS but decreased with SNS, VNS, and SNS + VNS (P < .05); MPO activity was decreased by SNS, VNS, and SNS + VNS; (c) SNS, VNS, and SNS + VNS remarkably increased vagal activity that was suppressed by TNBS (P < .05); (d) smilar SNS effects were noted in rats with DSS‐induced colitis. Conclusions & Inferences SNS presents similar anti‐inflammatory effects as VNS by inhibiting pro‐inflammatory cytokines and increasing anti‐inflammatory cytokines via the autonomic pathway. Similar to VNS, SNS may also have a therapeutic potential for colonic inflammation.

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“…One in five people suffer from FGID, and pharmaceutical intervention is often unsuccessful partly due to the lack of fundamental understanding of the colonic ENS [22][23][24][25] . An emerging alternative intervention is peripheral nerve stimulation [26][27][28][29][30] . Sacral nerve stimulation (SNS) in particular has been shown to be an effective therapy for fecal incontinence and constipation [31][32][33][34] .…”

mentioning

confidence: 99%

An intravital window to image the colon in real time

et al. 2019

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Intravital microscopy is a powerful technique to observe dynamic processes with single-cell resolution in live animals. No intravital window has been developed for imaging the colon due to its anatomic location and motility, although the colon is a key organ where the majority of microbiota reside and common diseases such as inflammatory bowel disease, functional gastrointestinal disorders, and colon cancer occur. Here we describe an intravital murine colonic window with a stabilizing ferromagnetic scaffold for chronic imaging, minimizing motion artifacts while maximizing long-term survival by preventing colonic obstruction. Using this setup, we image fluorescently-labeled stem cells, bacteria, and immune cells in live animal colons. Furthermore, we image nerve activity via calcium imaging in real time to demonstrate that electrical sacral nerve stimulation can activate colonic enteric neurons. The simple implantable apparatus enables visualization of live processes in the colon, which will open the window to a broad range of studies.

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Sacral nerve stimulation in the treatment of fecal incontinence – the experience of a pelvic floor center: Short-term results

Cited by 11 publications

References 10 publications

Risk Factors for Surgical Site Infection in Patients Undergoing Sacral Nerve Modulation Therapy

Risk Factors for Surgical Site Infection in Patients Undergoing Sacral Nerve Modulation Therapy

Sacral nerve stimulation improves colonic inflammation mediated by autonomic‐inflammatory cytokine mechanism in rats

An intravital window to image the colon in real time

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