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Title of Journal: Int J Colorectal Dis

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Abbravation: International Journal of Colorectal Disease

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Springer-Verlag

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DOI

10.1007/bf01173236

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1432-1262

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Permanent sacral nerve modulation for fecal incont

Authors: Donato F Altomare Marcella Rinaldi Maria Petrolino Vincenzo Monitillo Pierluca Sallustio Antonella Veglia Michele De Fazio Altomarino Guglielmi Vincenzo Memeo
Publish Date: 2003/09/12
Volume: 19, Issue: 3, Pages: 203-209
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Abstract

Sacral nerve modulation SNM using an implantable pulse generator is gaining increasing acceptance in the treatment of several functional disturbances of the urinary and intestinal tract This new therapeutic approach offers new possibilities in the treatment of fecal incontinence FI by means of its possible effects on anorectal physiologyFourteen patients with FI six of whom had associated urinary disturbances underwent permanent SNM after successful peripheral nerve evaluation tests All had a clinical evaluation including FI grading systems American Medical systems AMS Continence Grading System CGS and quality of life questionnaires Fecal Incontinence Quality of Life FIQL and anorectal physiology tests performed before and during electrostimulation Two patients had a lead displacement which was repositioned Median followup was 14 months range 6–48 monthsAMS scores decreased significantly from 101 to 67 after 24 months CGS scores from 15 to 2 after 2 months The median number of episodes of major incontinence per 2 weeks decreased from 14 to 1 after 24 months FIQL scores improved significantly in the nine patients tested from an overall score of 159 to 33 with improvement in all areas of the FIQL Four of the six patients with associated urinary disturbances had a significant improvement in their symptoms Anal resting and squeezing tone did not change significantly nor did rectal volumetry compliance rectoanal inhibitory reflex or length of the anal highpressure zone while 24h rectal manometry showed inhibition of the spontaneous rectal motility complexes after meal and on awakening in the only two patients undergoing this investigation

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