Top

Techniques in Coloproctology

Published in:

01-02-2018 | Original Article

Sacral neuromodulation in patients with congenital faecal incontinence. Special issues and review of the literature

Authors: L. Lagares-Tena, L. Millán-Paredes, L. Lázaro-García, A. Navarro-Luna, S. Delgado-Rivilla, A. Muñoz-Duyos

Published in: Techniques in Coloproctology | Issue 2/2018

Abstract

Background

The aim of the present study was to evaluate the effectiveness of sacral neuromodulation (SNM) as a treatment for congenital faecal incontinence (FI).

Methods

A retrospective study was conducted on patients with congenital FI who had SNM surgery at our institution between October 2005 and June 2013. An initial percutaneous nerve evaluation was performed, and patients with an improvement of more than 50% in their symptoms had permanently implants for SNM treatment.

Results

There were 4 patients who received a permanent implant. Mean duration of follow-up was 67.5 months (range 45–135 months). At last follow-up, 2 patients maintained significant improvement with SNM, 1 was explanted after 4 years of treatment due to infection but remained asymptomatic and SNM failed in the remaining patient who went on to graciloplasty.

Conclusions

SNM may be of value for treating FI in patients with anorectal malformations.

Muñoz-Duyos A, Navarro-Luna A, Marco-Molina C (2008) Proposal for a new consensus classification for faecal incontinence. Cir Esp 83(5):235–241CrossRefPubMed

Rigueros Springford L, Connor MJ, Jones K, Kapetanakis VV, Giuliani S (2016) Prevalence of active long-term problems in patients with anorectal malformations: a systematic review. Dis Colon Rectum 59(6):570–580. https://doi.org/10.1097/DCR.0000000000000576 CrossRefPubMed

Wetherill C, Sutcliffe J (2014) Hirschsprung disease and anorectal malformation. Early Hum Dev 90(12):927–932. https://doi.org/10.1016/j.earlhumdev.2014.09.016 CrossRefPubMed

Bischoff A, Frischer J, Knod JL et al (2016) Damaged anal canal as a cause of fecal incontinence after surgical repair for Hirschsprung disease—a preventable and under-reported complication. J Pediatr Surg 52(4):549–553. https://doi.org/10.1016/j.jpedsurg.2016.08.027 CrossRefPubMed

Van Kerrebroeck PE, Marcelissen TA (2012) Sacral neuromodulation for lower urinary tract dysfunction. World J Urol 30(4):445–450. https://doi.org/10.1007/s00345-011-0780-2 CrossRefPubMed

Altomare DF, Giuratrabocchetta S, Knowles CH, on behalf of the European SNS Outcome Study Group et al (2015) Long-term outcomes of sacral nerve stimulation for faecal incontinence. Br J Surg 102:407–415. https://doi.org/10.1002/bjs.9740 CrossRefPubMed

Thaha MA, Abukar AA, Thin NN, Ramsanahie A, Knowles CH et al (2015) Sacral nerve stimulation for faecal incontinence and constipation in adults. Cochrane Database Syst Rev 24(8):CD004464. https://doi.org/10.1002/14651858.cd004464.pub3

Lagares-Tena L, Corbella-Sala C, Navarro-Luna A, Muñoz-Duyos A (2017) Sacral neuromodulation in a faecal incontinence patient with unknown sacral partial agenesis. Colorectal Dis 19(5):502–504. https://doi.org/10.1111/codi.13661 CrossRefPubMed

Thomas GP, Nicholls RJ, Vaizey CJ (2013) Sacral nerve stimulation for faecal incontinence secondary to congenital imperforate anus. Tech Coloproctol 17(2):227–229. https://doi.org/10.1007/s10151-012-0914-6 CrossRefPubMed

10.

Brunner M, Cui Z, Matzel KE (2016) Sacral nerve stimulation for faecal incontinence in patients with sacral malformation. Int J Colorectal Dis. https://doi.org/10.1007/s00384-016-2748-6 PubMed

11.

Zurbuchen U, Groene J, Otto SD, Kreis ME, Maerzheuser S (2014) Sacral neuromodulation for fecal incontinence and constipation in adult patients with anorectal malformation–a feasibility study in patients with or without sacral dysgenesis. Int J Colorectal Dis 29(10):1297–1302. https://doi.org/10.1002/14651858.CD004464.pub3 CrossRefPubMed

12.

Altomare DF, Giannini I, Giuratrabocchetta S, Digennaro R (2013) The effects of sacral nerve stimulation on continence are temporarily maintained after turning the stimulator off. Colorectal Dis 15(12):e741–e748. https://doi.org/10.1111/codi.12418 CrossRefPubMed

13.

Grossi U, Carrington EV, Scott SM, Knowles CH (2014) Sacral neuromodulation for anorectal dysfunction secondary to congenital imperforate anus: report of two cases. Int J Colorectal Dis 29(7):889–890. https://doi.org/10.1007/s00384-014-1874-2 CrossRefPubMed

14.

Bloemendaal AL, Gorissen K, Prapasrivorakul S et al (2016) Sacral nerve stimulation for faecal incontinence due to imperforate anus in VATER/VACTERL association. Int J Colorectal Dis 31(3):777–778. https://doi.org/10.1007/s00384-015-2282-y CrossRefPubMed

15.

Eftaiha SM, Melich G, Pai A, Marecik SJ, Prasad LM, Park JJ (2016) Sacral nerve stimulation in the treatment of bowel dysfunction from imperforate anus: a case report. Int J Surg Case Rep 24:115–118. https://doi.org/10.1016/j.ijscr.2016.05.018 CrossRefPubMedPubMedCentral

Title: Sacral neuromodulation in patients with congenital faecal incontinence. Special issues and review of the literature
Authors: L. Lagares-Tena
L. Millán-Paredes
L. Lázaro-García
A. Navarro-Luna
S. Delgado-Rivilla
A. Muñoz-Duyos
Publication date: 01-02-2018
Publisher: Springer International Publishing
Published in: Techniques in Coloproctology / Issue 2/2018
Print ISSN: 1123-6337
Electronic ISSN: 1128-045X
DOI: https://doi.org/10.1007/s10151-017-1742-5

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Sacral neuromodulation in patients with congenital faecal incontinence. Special issues and review of the literature

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 2/2018

Random duodenal biopsy to exclude coeliac disease as a cause of anaemia is not cost-efective and should be replaced with universally performed pre-endoscopy serology in patients on a suspected cancer pathway

A prospective randomized trial on transanal hemorrhoidal dearterialization versus stapler hemorrhoidectomy: methodological issues that need to be clarified

Application of three-dimensional printing in laparoscopic dissection to facilitate D3-lymphadenectomy for right colon cancer

Effectiveness of sacral nerve stimulation in fecal incontinence after multimodal oncologic treatment for pelvic malignancies: a multicenter study with 2-year follow-up

Micro-fragmented adipose tissue injection for the treatment of complex anal fistula: a pilot study accessing safety and feasibility

Reversal of Hartmann’s procedure: still a complicated operation