[Indications and results of sacral nerve stimulation in faecal incontinence].

Abstract:

BACKGROUND:Sacral nerve stimulation (SNS) is an effective and less invasive treatment of faecal incontinence (FI). Patient selection has evolved from strict criteria to a more liberal approach, since temporary testing reliably predicts the efficacy of permanent stimulation in FI of various aetiologies. PATIENTS AND METHODS:From November 2005 until June 2007, we evaluated 20 consecutive patients (17 females, 3 males) with FI by percutaneous nerve evaluation (PNE), i. e., temporary stimulation. 13 patients proceeded to a permanent implantation of a pulse generator (3 bilateral generators). 11 patients with permanent stimulation were eligible for a minimum follow-up of 3 months. Median follow-up for this group was 10 (range 3-19) months. All patients provided bowel diaries, the disease-specific quality of life questionnaire of the American Society of Colon and Rectal Surgeons (ASCRS), and the Standard Short Form Health Survey Questionnaire (SF-36) at baseline, screening and at the follow-up. RESULTS:The aetiologies of the FI were pelvic floor insufficiency (n = 12), history of anterior resection (n = 3), history of surgery for disk prolaps (n = 2), sphincter disruption (n = 1), history of surgery for recto-vaginal fistula (n = 1), and idiopathic (n = 1). The mean number of incontinence episodes dropped from 9.9 to 1.3 during temporary testing (p = 0.02) and to 4.5 at last follow-up (p = 0.043). The quality of life assessment showed a significant improvement in the subscale embarrassment of the ASCRS (p = 0.043). There were 2 minor postoperative complications, and 1 medium-term failure of SNS treatment. CONCLUSION:SNS is a minimally invasive and effective treatment of FI. A pragmatic approach is justified due to the possibility of temporary testing and the low rate of complications.

journal_name

Zentralbl Chir

authors

Stelzner S,Köhler K,Hellmich G,Witzigmann H

doi

10.1055/s-2008-1004737

subject

Has Abstract

pub_date

2008-04-01 00:00:00

pages

135-41

issue

2

eissn

0044-409X

issn

1438-9592

journal_volume

133

pub_type

杂志文章
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