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01-09-2004 | Original Contributions

Sacral Neuromodulation in Patients With Fecal Incontinence: A Single-Center Study

Authors: Özenç Uludağ, M.D., Sacha M. P. Koch, M.D., Wim G. van Gemert, Ph.D., Cees H. C. Dejong, Ph.D., Cor G. M. I. Baeten, Ph.D.

Published in: Diseases of the Colon & Rectum | Issue 9/2004

PURPOSE:

Fecal incontinence is a psychologically devastating and socially incapacitating condition. Conventional treatment is likely to improve continence in many patients; however, there remains a group with persisting symptoms who are not amenable for a simple surgical repair. We evaluated the effect of sacral neuromodulation in patients with structurally intact sphincters after failure of conventional treatment.

METHODS:

Patients aged 18 to 75 years were evaluated. Incontinence was defined as involuntary loss of stool at least once per week, which was objectified by completion of a three-week bowel-habits diary during ambulatory electrode stimulation at the S3 or S4 foramen. Patients were qualified for permanent stimulation when showing a reduction of at least 50 percent in incontinence episodes or days.

RESULTS:

Seventy-five patients (66 females; mean age, 52 (range, 26–75) years) were treated. Three patients had partial spinal cord injury, two patients a previous low-anterior resection, and nine patients had a previous sphincter repair. Evaluation after trial screening showed that 62 patients (83 percent) had improved continence. Median incontinence episodes per week decreased from 7.5 to 0.67 (P < 0.01), median incontinence days per week from 4 to 0.5 (P < 0.01). The symptomatic response stayed unchanged after implantation of a permanent electrode and pacemaker in 50 patients. After a median follow-up of 12 months, this effect could be sustained in 48 patients. Anal manometry during stimulation showed no increase of sphincter pressures.

CONCLUSIONS:

Sacral neuromodulation is a feasible treatment option for fecal incontinence in patients with structurally intact sphincters.

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Title: Sacral Neuromodulation in Patients With Fecal Incontinence: A Single-Center Study
Authors: Özenç Uludağ, M.D.
Sacha M. P. Koch, M.D.
Wim G. van Gemert, Ph.D.
Cees H. C. Dejong, Ph.D.
Cor G. M. I. Baeten, Ph.D.
Publication date: 01-09-2004
Publisher: Springer-Verlag
Published in: Diseases of the Colon & Rectum / Issue 9/2004
Print ISSN: 0012-3706
Electronic ISSN: 1530-0358
DOI: https://doi.org/10.1007/s10350-004-0589-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Sacral Neuromodulation in Patients With Fecal Incontinence: A Single-Center Study

PURPOSE:

METHODS:

RESULTS:

CONCLUSIONS:

Keynote webinar | Spotlight on medication adherence

Springer Medicine

PURPOSE:

METHODS:

RESULTS:

CONCLUSIONS:

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