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Erschienen in:
01.01.2015 | 2014 SSAT Plenary Presentation
Is Sacral Neuromodulation Here to Stay? Clinical Outcomes of a New Treatment for Fecal Incontinence
Erschienen in: Journal of Gastrointestinal Surgery | Ausgabe 1/2015
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Introduction
Sacral neuromodulation (SNM) was approved by the FDA for the treatment of fecal incontinence (FI) in 2011, and previous industry-sponsored trials have shown excellent clinical outcomes. The purpose of this study is to examine clinical outcomes of patients treated during our initial experience with SNM.
Methods
A prospective database of patients treated with SNM for FI by one of three colorectal surgeons at two separate institutions was maintained starting in 2011. Patients showing ≥50 % improvement of weekly incontinent episodes during test stimulation were offered permanent implantation of the SNM device. Disease severity was tracked using the Wexner score.
Results
A total of 145 patients received a full system implantation (of 152 who received test stimulation). The median preoperative Wexner score of 14 decreased to 3, 3 months after implantation and persisted to 12 months. At 12 months, 95.2 % of patients achieved >50 % improvement in Wexner Score and 67.6 % achieved >75 % improvement. The most common adverse event was infection (3.4 %). Three patients (2.1 %) required lead revision.
Conclusions
SNM is a safe and effective therapy for the treatment of FI. Postoperative patient surveillance is important, as many patients require programming changes, and some will require a lead revision over time.