Top

International Journal of Colorectal Disease

Published in:

01-02-2016 | Original Article

Sacral nerve stimulation for faecal incontinence—efficacy confirmed from a two-centre prospectively maintained database

Authors: Jakob Duelund-Jakobsen, Paul-Antoine Lehur, Lilli Lundby, Vincent Wyart, Søren Laurberg, Steen Buntzen

Published in: International Journal of Colorectal Disease | Issue 2/2016

Abstract

Introduction

Sacral nerve stimulation (SNS) has been recognised as an effective treatment for faecal incontinence. Many unresolved questions could be answered when comparing large data-series from different centres providing prospective data.

Aim

To present data, from an international two-centre SNS prospective database (SNSPD) on functional outcome and management of surgical complications in patients treated with SNS for faecal incontinence.

Method

The SNSPD was designed in order to gather detailed pre- and perioperative information followed by a close follow-up in all patients undergoing SNS for bowel dysfunction. The SNSPD was open for inclusion of newly SNS implanted patients in May 2009, and closed on 31 December 2013. Two-centres Aarhus, Denmark, and Nantes, France, included and monitored all patients implanted due to bowel dysfunction according to database criteria.

Results

In total, 164 faecal incontinent patients with a median follow-up of 22 (range 1–50) months were implanted. The Wexner incontinence score improved from 15 (range, 3–20) at baseline to 9 (range, 0–20) at latest follow-up (P < 0.001) and VAS impact on daily life improved from 85.5 (range, 3–100) to 20 (range, 0–100) (P < 0.001). Additional surgical intervention was required in 19.5 % during follow-up. Repositioning of the pacemaker due to pain or migration was the most common complication in 12.1 %. Infections leading to explantation occurred in 3.0 %.

Matzel KE, Kamm MA, Stosser M, Baeten CG, Christiansen J, Madoff R et al (2004) Sacral spinal nerve stimulation for faecal incontinence: multicentre study. Lancet 363(9417):1270–1276CrossRefPubMed

Thomas GP, Dudding TC, Rahbour G, Nicholls RJ, Vaizey CJ (2013) Sacral nerve stimulation for constipation. Br J Surg 100(2):174–181CrossRefPubMed

Fassov JL, Lundby L, Laurberg S, Buntzen S, Krogh K (2014) A randomized, controlled, crossover study of sacral nerve stimulation for irritable bowel syndrome. Ann Surg 260(1):31–36CrossRefPubMed

Dudding TC, Thomas GP, Hollingshead JR, George AT, Stern J, Vaizey CJ (2013) Sacral nerve stimulation: an effective treatment for chronic functional anal pain? Colorectal Dis 15(9):1140–1144PubMed

Kenefick NJ, Vaizey CJ, Nicholls RJ, Cohen R, Kamm MA (2002) Sacral nerve stimulation for faecal incontinence due to systemic sclerosis. Gut 51(6):881–883PubMedCentralCrossRefPubMed

Johanson JF, Lafferty J (1996) Epidemiology of fecal incontinence: the silent affliction. Am J Gastroenterol 91(1):33–36PubMed

Kalantar JS, Howell S, Talley NJ (2002) Prevalence of faecal incontinence and associated risk factors; an underdiagnosed problem in the Australian community? MedJAust 176(2):54–57

Pretlove SJ, Radley S, Toozs-Hobson PM, Thompson PJ, Coomarasamy A, Khan KS (2006) Prevalence of anal incontinence according to age and gender: a systematic review and meta-regression analysis. IntUrogynecolJPelvic Floor Dysfunct 17(4):407–417CrossRef

Damon H, Guye O, Seigneurin A, Long F, Sonko A, Faucheron JL et al (2006) Prevalence of anal incontinence in adults and impact on quality-of-life. Gastroenterol Clin Biol 30(1):37–43CrossRefPubMed

10.

Makol A, Grover M, Whitehead WE (2008) Fecal incontinence in women: causes and treatment. Womens Health(LondEngl) 4(5):517–528

11.

Christensen P, Krogh K, Buntzen S, Payandeh F, Laurberg S (2009) Long-term outcome and safety of transanal irrigation for constipation and fecal incontinence. Dis Colon Rectum 52(2):286–292CrossRefPubMed

12.

Abrams P, Andersson KE, Birder L, Brubaker L, Cardozo L, Chapple C et al (2010) Fourth international consultation on incontinence recommendations of the international scientific committee: evaluation and treatment of urinary incontinence, pelvic organ prolapse, and fecal incontinence. Neurourol Urodyn 29(1):213–240CrossRefPubMed

13.

Matzel KE, Stadelmaier U, Hohenfellner M, Gall FP (1995) Electrical stimulation of sacral spinal nerves for treatment of faecal incontinence. Lancet 346(8983):1124–1127CrossRefPubMed

14.

Uludag O, Koch SM, van Gemert WG, Dejong CH, Baeten CG (2004) Sacral neuromodulation in patients with fecal incontinence: a single-center study. Dis Colon Rectum 47(8):1350–1357CrossRefPubMed

15.

Altomare DF, Ratto C, Ganio E, Lolli P, Masin A, Villani RD (2009) Long-term outcome of sacral nerve stimulation for fecal incontinence. Dis Colon Rectum 52(1):11–17CrossRefPubMed

16.

Melenhorst J, Koch SM, Uludag O, van Gemert WG, Baeten CG (2007) Sacral neuromodulation in patients with faecal incontinence: results of the first 100 permanent implantations. Colorectal Dis 9(8):725–730CrossRefPubMed

17.

Michelsen HB, Thompson-Fawcett M, Lundby L, Krogh K, Laurberg S, Buntzen S (2010) Six years of experience with sacral nerve stimulation for fecal incontinence. Dis Colon Rectum 53(4):414–421CrossRefPubMed

18.

Hull T, Giese C, Wexner SD, Mellgren A, Devroede G, Madoff RD et al (2013) Long-term durability of sacral nerve stimulation therapy for chronic fecal incontinence. Dis Colon Rectum 56(2):234–245CrossRefPubMed

19.

Altomare DF, Giuratrabocchetta S, Knowles CH, Munoz Duyos A, Robert-Yap J, Matzel KE et al (2015) Long-term outcomes of sacral nerve stimulation for faecal incontinence. Br J Surg 102(4):407–415CrossRefPubMed

20.

Rasmussen OO, Buntzen S, Sorensen M, Laurberg S, Christiansen J (2004) Sacral nerve stimulation in fecal incontinence. Dis Colon Rectum 47(7):1158–1162, discussion 1162-3CrossRefPubMed

21.

Wexner SD, Coller JA, Devroede G, Hull T, McCallum R, Chan M et al (2010) Sacral nerve stimulation for fecal incontinence: results of a 120-patient prospective multicenter study. Ann Surg 251(3):441–449CrossRefPubMed

22.

Emmertsen KJ, Laurberg S (2012) Low anterior resection syndrome score: development and validation of a symptom-based scoring system for bowel dysfunction after low anterior resection for rectal cancer. Ann Surg 255(5):922–928CrossRefPubMed

23.

Duelund-Jakobsen J, van Wunnik B, Buntzen S, Lundby L, Baeten C, Laurberg S (2012) Functional results and patient satisfaction with sacral nerve stimulation for idiopathic faecal incontinence. Colorectal Dis 14(6):753–759CrossRefPubMed

24.

Tjandra JJ, Chan MK, Yeh CH, Murray-Green C (2008) Sacral nerve stimulation is more effective than optimal medical therapy for severe fecal incontinence: a randomized, controlled study. Dis Colon Rectum 51(5):494–502CrossRefPubMed

25.

Duelund-Jakobsen J, Haas S, Buntzen S, Lundby L, Boje G, Laurberg S (2015) Nurse led clinics can manage faecal incontinence effectively: results from a tertiary referral centre. Colorectal Dis 17:710–715CrossRefPubMed

26.

Mellgren A, Wexner SD, Coller JA, Devroede G, Lerew DR, Madoff RD et al (2011) Long-term efficacy and safety of sacral nerve stimulation for fecal incontinence. Dis Colon Rectum 54(9):1065–1075CrossRefPubMed

27.

Maeda Y, Lundby L, Buntzen S, Laurberg S (2011) Suboptimal outcome following sacral nerve stimulation for faecal incontinence. Br J Surg 98(1):140–147CrossRefPubMed

28.

Faucheron JL, Bost R, Duffournet V, Dupuy S, Cardin N, Bonaz B (2006) Sacral neuromodulation in the treatment of severe anal incontinence. Forty consecutive cases treated in one institution. Gastroenterol Clin Biol 30(5):669–672CrossRefPubMed

29.

Gallas S, Michot F, Faucheron JL, Meurette G, Lehur PA, Barth X et al (2010) Predictive factors for successful sacral nerve stimulation in the treatment of faecal incontinence: results of trial stimulation in 200 patients. Colorectal Dis 97:108–112

30.

Jorge JM, Wexner SD (1993) Etiology and management of fecal incontinence. Dis Colon Rectum 36(1):77–97CrossRefPubMed

31.

Vaizey CJ, Carapeti E, Cahill JA, Kamm MA (1999) Prospective comparison of faecal incontinence grading systems. Gut 44(1):77–80PubMedCentralCrossRefPubMed

32.

Agachan F, Chen T, Pfeifer J, Reissman P, Wexner SD (1996) A constipation scoring system to simplify evaluation and management of constipated patients. Dis Colon Rectum 39(6):681–685CrossRefPubMed

33.

Altomare DF, Spazzafumo L, Rinaldi M, Dodi G, Ghiselli R, Piloni V (2008) Set-up and statistical validation of a new scoring system for obstructed defaecation syndrome. Colorectal Dis 10(1):84–88PubMed

34.

Wiklund IK, Fullerton S, Hawkey CJ, Jones RH, Longstreth GF, Mayer EA et al (2003) An irritable bowel syndrome-specific symptom questionnaire: development and validation. Scand J Gastroenterol 38(9):947–954CrossRefPubMed

Title: Sacral nerve stimulation for faecal incontinence—efficacy confirmed from a two-centre prospectively maintained database
Authors: Jakob Duelund-Jakobsen
Paul-Antoine Lehur
Lilli Lundby
Vincent Wyart
Søren Laurberg
Steen Buntzen
Publication date: 01-02-2016
Publisher: Springer Berlin Heidelberg
Published in: International Journal of Colorectal Disease / Issue 2/2016
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI: https://doi.org/10.1007/s00384-015-2411-7

At a glance: The STEP trials

Springer Medicine

Sacral nerve stimulation for faecal incontinence—efficacy confirmed from a two-centre prospectively maintained database

Abstract

Introduction

Aim

Method

Results

At a glance: The STEP trials

Springer Medicine

Abstract

Introduction

Aim

Method

Results

Please log in to get access to this content

Other articles of this Issue 2/2016

The frequency of early colorectal cancer derived from sessile serrated adenoma/polyps among 1858 serrated polyps from a single institution

Health status, anxiety, and depressive symptoms following complicated and uncomplicated colorectal surgeries

Is transanal total mesorectal excision a reproducible and oncologically adequate technique? A pilot study in a single center

CT imaging for prediction of complications and recurrence in acute uncomplicated diverticulitis

Rectal cancer with complete clinical response after neoadjuvant chemoradiotherapy, surgery, or “watch and wait”

Laparoscopic versus robotic-assisted colectomy and rectal resection: a systematic review and meta-analysis