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International Journal of Colorectal Disease

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01-09-2021 | Ulcerative Colitis | Original Article

Sacral nerve stimulation in patients with ileal pouch-anal anastomosis

Authors: C. Seifarth, N. Slavova, C. Degro, K. S. Lehmann, M. E. Kreis, B. Weixler

Published in: International Journal of Colorectal Disease | Issue 9/2021

Abstract

Purpose

Functional results after proctocolectomy and ileal pouch-anal anastomosis (IPAA) are generally good. However, some patients suffer from high stool frequency or fecal incontinence. Sacral nerve stimulation (SNS) may represent a therapeutic alternative in these patients, but little is known about indication and results. The aim of this study was to evaluate incontinence after IPAA and demonstrate SNS feasibility in these patients.

Methods

This retrospective study includes patients who received a SNS between 1993 and 2020 for increased stool frequency or fecal incontinence after proctocolectomy with IPAA for ulcerative colitis. Proctocolectomy was performed in a two- or three-step approach with ileostomy closure as the last step. Demographic, follow-up data and functional results were obtained from the hospital database.

Results

SNS was performed in 23 patients. Median follow-up time after SNS was 6.5 years (min. 4.2–max. 8.8). Two patients were lost to follow-up. The median time from ileostomy closure to SNS implantation was 6 years (min. 0.5–max. 14.5). Continence after SNS improved in 16 patients (69%) with a median St. Marks score for anal incontinence of 19 (min. 4–max. 22) before SNS compared to 4 (0–10) after SNS placement (p = 0.012). In seven patients, SNS therapy was not successful.

Conclusion

SNS implantation improves symptoms in over two-thirds of patients suffering from high stool frequency or fecal incontinence after proctocolectomy with IPAA. Awareness of the beneficial effects of SNS should be increased in physicians involved in the management of these patients.

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Title: Sacral nerve stimulation in patients with ileal pouch-anal anastomosis
Authors: C. Seifarth
N. Slavova
C. Degro
K. S. Lehmann
M. E. Kreis
B. Weixler
Publication date: 01-09-2021
Publisher: Springer Berlin Heidelberg
Keywords: Ulcerative Colitis
Proctocolectomy
Proctocolectomy
Fecal Incontinence
Nerve Stimulation
Published in: International Journal of Colorectal Disease / Issue 9/2021
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI: https://doi.org/10.1007/s00384-021-03981-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Sacral nerve stimulation in patients with ileal pouch-anal anastomosis

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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