Long-term Durability of Sacral Nerve Stimulation Therapy for Chronic Fecal Incontinence
BACKGROUND:Limited data have been published regarding the long-term results of sacral nerve stimulation, or sacral neuromodulation, for severe fecal incontinence. OBJECTIVES:The aim was to assess the outcome of sacral nerve stimulation with the use of precise tools and data collection, focusing on t...
Gespeichert in:
| Veröffentlicht in: | Diseases of the colon & rectum 2013-02, Vol.56 (2), p.234-245 |
|---|---|
| Hauptverfasser: | , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 245 |
|---|---|
| container_issue | 2 |
| container_start_page | 234 |
| container_title | Diseases of the colon & rectum |
| container_volume | 56 |
| creator | Hull, Tracy Giese, Chad Wexner, Steven D Mellgren, Anders Devroede, Ghislain Madoff, Robert D Stromberg, Katherine Coller, John A |
| description | BACKGROUND:Limited data have been published regarding the long-term results of sacral nerve stimulation, or sacral neuromodulation, for severe fecal incontinence.
OBJECTIVES:The aim was to assess the outcome of sacral nerve stimulation with the use of precise tools and data collection, focusing on the long-term durability of the therapy. Five-year data were analyzed.
DESIGN:Patients entered in a multicenter, prospective study for fecal incontinence were followed at 3, 6, and 12 months and annually after device implantation.
PATIENTS:Patients with chronic fecal incontinence in whom conservative treatments had failed or who were not candidates for more conservative treatments were selected.
INTERVENTIONS:Patients with ≥50% improvement over baseline in fecal incontinence episodes per week during a 14-day test stimulation period received sacral nerve stimulation therapy.
MAIN OUTCOME MEASURES:Patients were assessed with a 14-day bowel diary and Fecal Incontinence Quality of Life and Fecal Incontinence Severity Index questionnaires. Therapeutic success was defined as ≥50% improvement over baseline in fecal incontinence episodes per week. All adverse events were collected.
RESULTS:A total of 120 patients (110 women; mean age, 60.5 years) underwent implantation. Seventy-six of these patients (63%) were followed a minimum of 5 years (maximum, longer than 8 years) and are the basis for this report. Fecal incontinence episodes per week decreased from a mean of 9.1 at baseline to 1.7 at 5 years, with 89% (n = 64/72) having ≥50% improvement (p < 0.0001) and 36% (n = 26/72) having complete continence. Fecal Incontinence Quality of Life scores also significantly improved for all 4 scales between baseline and 5 years (n = 70; p < 0.0001). Twenty-seven of the 76 (35.5%) patients required a device revision, replacement, or explant.
CONCLUSIONS:The therapeutic effect and improved quality of life for fecal incontinence is maintained 5 years after sacral nerve stimulation implantation and beyond. Device revision, replacement, or explant rate was acceptable, but future efforts should be aimed at improvement. |
| doi_str_mv | 10.1097/DCR.0b013e318276b24c |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1285466870</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1285466870</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4484-ec99de7fc1377fbb50efaf0588212678489fc498af064cdfd18c284193722bcb3</originalsourceid><addsrcrecordid>eNpdkV1rFDEUhoModlv9ByK5EbyZevIxk8ylbFstLAq24mXIZE_caGayJjOW_femdLVgbkIOz8kLz0vIKwbnDHr17mL95RwGYAIF01x1A5fuCVmxVkADotVPyQqA8UYo6E7IaSk_6hM4qOfkhAsBopIr8m2Tpu_NjHmkF0u2Q4hhPtDk6Y112Ub6CfNvpDdzGJdo55AmervDbPcH6lOm611OU3D0Cl1lryeXpjlMODl8QZ55Gwu-PN5n5OvV5e36Y7P5_OF6_X7TOCm1bND1_RaVd0wo5YehBfTWQ6s1Z7xTWureO9nrOuuk2_ot045ryXqhOB_cIM7I24d_9zn9WrDMZgzFYYx2wrQUw7huZddpBRWVD6jLqZSM3uxzGG0-GAbmXqmpSs3_Suva62PCMoy4_bf012EF3hwBW6oGn-3kQnnkFEjeCvmYf5diFV5-xuUOs9mhjfPOQD1CtqLhNb_WBLXFWpgUfwD6k473</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1285466870</pqid></control><display><type>article</type><title>Long-term Durability of Sacral Nerve Stimulation Therapy for Chronic Fecal Incontinence</title><source>MEDLINE</source><source>Journals@Ovid Complete</source><creator>Hull, Tracy ; Giese, Chad ; Wexner, Steven D ; Mellgren, Anders ; Devroede, Ghislain ; Madoff, Robert D ; Stromberg, Katherine ; Coller, John A</creator><creatorcontrib>Hull, Tracy ; Giese, Chad ; Wexner, Steven D ; Mellgren, Anders ; Devroede, Ghislain ; Madoff, Robert D ; Stromberg, Katherine ; Coller, John A ; SNS Study Group</creatorcontrib><description>BACKGROUND:Limited data have been published regarding the long-term results of sacral nerve stimulation, or sacral neuromodulation, for severe fecal incontinence.
OBJECTIVES:The aim was to assess the outcome of sacral nerve stimulation with the use of precise tools and data collection, focusing on the long-term durability of the therapy. Five-year data were analyzed.
DESIGN:Patients entered in a multicenter, prospective study for fecal incontinence were followed at 3, 6, and 12 months and annually after device implantation.
PATIENTS:Patients with chronic fecal incontinence in whom conservative treatments had failed or who were not candidates for more conservative treatments were selected.
INTERVENTIONS:Patients with ≥50% improvement over baseline in fecal incontinence episodes per week during a 14-day test stimulation period received sacral nerve stimulation therapy.
MAIN OUTCOME MEASURES:Patients were assessed with a 14-day bowel diary and Fecal Incontinence Quality of Life and Fecal Incontinence Severity Index questionnaires. Therapeutic success was defined as ≥50% improvement over baseline in fecal incontinence episodes per week. All adverse events were collected.
RESULTS:A total of 120 patients (110 women; mean age, 60.5 years) underwent implantation. Seventy-six of these patients (63%) were followed a minimum of 5 years (maximum, longer than 8 years) and are the basis for this report. Fecal incontinence episodes per week decreased from a mean of 9.1 at baseline to 1.7 at 5 years, with 89% (n = 64/72) having ≥50% improvement (p < 0.0001) and 36% (n = 26/72) having complete continence. Fecal Incontinence Quality of Life scores also significantly improved for all 4 scales between baseline and 5 years (n = 70; p < 0.0001). Twenty-seven of the 76 (35.5%) patients required a device revision, replacement, or explant.
CONCLUSIONS:The therapeutic effect and improved quality of life for fecal incontinence is maintained 5 years after sacral nerve stimulation implantation and beyond. Device revision, replacement, or explant rate was acceptable, but future efforts should be aimed at improvement.</description><identifier>ISSN: 0012-3706</identifier><identifier>EISSN: 1530-0358</identifier><identifier>DOI: 10.1097/DCR.0b013e318276b24c</identifier><identifier>PMID: 23303153</identifier><identifier>CODEN: DICRAG</identifier><language>eng</language><publisher>Hagerstown, MDc: The ASCRS</publisher><subject>Anal Canal - innervation ; Biological and medical sciences ; Chronic Disease ; Electric Stimulation Therapy - instrumentation ; Electric Stimulation Therapy - methods ; Electrodes, Implanted ; Fecal Incontinence - therapy ; Female ; Follow-Up Studies ; Gastroenterology. Liver. Pancreas. Abdomen ; Humans ; Male ; Medical sciences ; Other diseases. Semiology ; Quality of Life ; Sacrum - innervation ; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus ; Surveys and Questionnaires ; Treatment Outcome</subject><ispartof>Diseases of the colon & rectum, 2013-02, Vol.56 (2), p.234-245</ispartof><rights>The ASCRS 2013</rights><rights>2014 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4484-ec99de7fc1377fbb50efaf0588212678489fc498af064cdfd18c284193722bcb3</citedby><cites>FETCH-LOGICAL-c4484-ec99de7fc1377fbb50efaf0588212678489fc498af064cdfd18c284193722bcb3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=27042534$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23303153$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hull, Tracy</creatorcontrib><creatorcontrib>Giese, Chad</creatorcontrib><creatorcontrib>Wexner, Steven D</creatorcontrib><creatorcontrib>Mellgren, Anders</creatorcontrib><creatorcontrib>Devroede, Ghislain</creatorcontrib><creatorcontrib>Madoff, Robert D</creatorcontrib><creatorcontrib>Stromberg, Katherine</creatorcontrib><creatorcontrib>Coller, John A</creatorcontrib><creatorcontrib>SNS Study Group</creatorcontrib><title>Long-term Durability of Sacral Nerve Stimulation Therapy for Chronic Fecal Incontinence</title><title>Diseases of the colon & rectum</title><addtitle>Dis Colon Rectum</addtitle><description>BACKGROUND:Limited data have been published regarding the long-term results of sacral nerve stimulation, or sacral neuromodulation, for severe fecal incontinence.
OBJECTIVES:The aim was to assess the outcome of sacral nerve stimulation with the use of precise tools and data collection, focusing on the long-term durability of the therapy. Five-year data were analyzed.
DESIGN:Patients entered in a multicenter, prospective study for fecal incontinence were followed at 3, 6, and 12 months and annually after device implantation.
PATIENTS:Patients with chronic fecal incontinence in whom conservative treatments had failed or who were not candidates for more conservative treatments were selected.
INTERVENTIONS:Patients with ≥50% improvement over baseline in fecal incontinence episodes per week during a 14-day test stimulation period received sacral nerve stimulation therapy.
MAIN OUTCOME MEASURES:Patients were assessed with a 14-day bowel diary and Fecal Incontinence Quality of Life and Fecal Incontinence Severity Index questionnaires. Therapeutic success was defined as ≥50% improvement over baseline in fecal incontinence episodes per week. All adverse events were collected.
RESULTS:A total of 120 patients (110 women; mean age, 60.5 years) underwent implantation. Seventy-six of these patients (63%) were followed a minimum of 5 years (maximum, longer than 8 years) and are the basis for this report. Fecal incontinence episodes per week decreased from a mean of 9.1 at baseline to 1.7 at 5 years, with 89% (n = 64/72) having ≥50% improvement (p < 0.0001) and 36% (n = 26/72) having complete continence. Fecal Incontinence Quality of Life scores also significantly improved for all 4 scales between baseline and 5 years (n = 70; p < 0.0001). Twenty-seven of the 76 (35.5%) patients required a device revision, replacement, or explant.
CONCLUSIONS:The therapeutic effect and improved quality of life for fecal incontinence is maintained 5 years after sacral nerve stimulation implantation and beyond. Device revision, replacement, or explant rate was acceptable, but future efforts should be aimed at improvement.</description><subject>Anal Canal - innervation</subject><subject>Biological and medical sciences</subject><subject>Chronic Disease</subject><subject>Electric Stimulation Therapy - instrumentation</subject><subject>Electric Stimulation Therapy - methods</subject><subject>Electrodes, Implanted</subject><subject>Fecal Incontinence - therapy</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Gastroenterology. Liver. Pancreas. Abdomen</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Other diseases. Semiology</subject><subject>Quality of Life</subject><subject>Sacrum - innervation</subject><subject>Stomach. Duodenum. Small intestine. Colon. Rectum. Anus</subject><subject>Surveys and Questionnaires</subject><subject>Treatment Outcome</subject><issn>0012-3706</issn><issn>1530-0358</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkV1rFDEUhoModlv9ByK5EbyZevIxk8ylbFstLAq24mXIZE_caGayJjOW_femdLVgbkIOz8kLz0vIKwbnDHr17mL95RwGYAIF01x1A5fuCVmxVkADotVPyQqA8UYo6E7IaSk_6hM4qOfkhAsBopIr8m2Tpu_NjHmkF0u2Q4hhPtDk6Y112Ub6CfNvpDdzGJdo55AmervDbPcH6lOm611OU3D0Cl1lryeXpjlMODl8QZ55Gwu-PN5n5OvV5e36Y7P5_OF6_X7TOCm1bND1_RaVd0wo5YehBfTWQ6s1Z7xTWureO9nrOuuk2_ot045ryXqhOB_cIM7I24d_9zn9WrDMZgzFYYx2wrQUw7huZddpBRWVD6jLqZSM3uxzGG0-GAbmXqmpSs3_Suva62PCMoy4_bf012EF3hwBW6oGn-3kQnnkFEjeCvmYf5diFV5-xuUOs9mhjfPOQD1CtqLhNb_WBLXFWpgUfwD6k473</recordid><startdate>201302</startdate><enddate>201302</enddate><creator>Hull, Tracy</creator><creator>Giese, Chad</creator><creator>Wexner, Steven D</creator><creator>Mellgren, Anders</creator><creator>Devroede, Ghislain</creator><creator>Madoff, Robert D</creator><creator>Stromberg, Katherine</creator><creator>Coller, John A</creator><general>The ASCRS</general><general>Lippincott Williams & Wilkins</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201302</creationdate><title>Long-term Durability of Sacral Nerve Stimulation Therapy for Chronic Fecal Incontinence</title><author>Hull, Tracy ; Giese, Chad ; Wexner, Steven D ; Mellgren, Anders ; Devroede, Ghislain ; Madoff, Robert D ; Stromberg, Katherine ; Coller, John A</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4484-ec99de7fc1377fbb50efaf0588212678489fc498af064cdfd18c284193722bcb3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Anal Canal - innervation</topic><topic>Biological and medical sciences</topic><topic>Chronic Disease</topic><topic>Electric Stimulation Therapy - instrumentation</topic><topic>Electric Stimulation Therapy - methods</topic><topic>Electrodes, Implanted</topic><topic>Fecal Incontinence - therapy</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Gastroenterology. Liver. Pancreas. Abdomen</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Other diseases. Semiology</topic><topic>Quality of Life</topic><topic>Sacrum - innervation</topic><topic>Stomach. Duodenum. Small intestine. Colon. Rectum. Anus</topic><topic>Surveys and Questionnaires</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hull, Tracy</creatorcontrib><creatorcontrib>Giese, Chad</creatorcontrib><creatorcontrib>Wexner, Steven D</creatorcontrib><creatorcontrib>Mellgren, Anders</creatorcontrib><creatorcontrib>Devroede, Ghislain</creatorcontrib><creatorcontrib>Madoff, Robert D</creatorcontrib><creatorcontrib>Stromberg, Katherine</creatorcontrib><creatorcontrib>Coller, John A</creatorcontrib><creatorcontrib>SNS Study Group</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Diseases of the colon & rectum</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hull, Tracy</au><au>Giese, Chad</au><au>Wexner, Steven D</au><au>Mellgren, Anders</au><au>Devroede, Ghislain</au><au>Madoff, Robert D</au><au>Stromberg, Katherine</au><au>Coller, John A</au><aucorp>SNS Study Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Long-term Durability of Sacral Nerve Stimulation Therapy for Chronic Fecal Incontinence</atitle><jtitle>Diseases of the colon & rectum</jtitle><addtitle>Dis Colon Rectum</addtitle><date>2013-02</date><risdate>2013</risdate><volume>56</volume><issue>2</issue><spage>234</spage><epage>245</epage><pages>234-245</pages><issn>0012-3706</issn><eissn>1530-0358</eissn><coden>DICRAG</coden><abstract>BACKGROUND:Limited data have been published regarding the long-term results of sacral nerve stimulation, or sacral neuromodulation, for severe fecal incontinence.
OBJECTIVES:The aim was to assess the outcome of sacral nerve stimulation with the use of precise tools and data collection, focusing on the long-term durability of the therapy. Five-year data were analyzed.
DESIGN:Patients entered in a multicenter, prospective study for fecal incontinence were followed at 3, 6, and 12 months and annually after device implantation.
PATIENTS:Patients with chronic fecal incontinence in whom conservative treatments had failed or who were not candidates for more conservative treatments were selected.
INTERVENTIONS:Patients with ≥50% improvement over baseline in fecal incontinence episodes per week during a 14-day test stimulation period received sacral nerve stimulation therapy.
MAIN OUTCOME MEASURES:Patients were assessed with a 14-day bowel diary and Fecal Incontinence Quality of Life and Fecal Incontinence Severity Index questionnaires. Therapeutic success was defined as ≥50% improvement over baseline in fecal incontinence episodes per week. All adverse events were collected.
RESULTS:A total of 120 patients (110 women; mean age, 60.5 years) underwent implantation. Seventy-six of these patients (63%) were followed a minimum of 5 years (maximum, longer than 8 years) and are the basis for this report. Fecal incontinence episodes per week decreased from a mean of 9.1 at baseline to 1.7 at 5 years, with 89% (n = 64/72) having ≥50% improvement (p < 0.0001) and 36% (n = 26/72) having complete continence. Fecal Incontinence Quality of Life scores also significantly improved for all 4 scales between baseline and 5 years (n = 70; p < 0.0001). Twenty-seven of the 76 (35.5%) patients required a device revision, replacement, or explant.
CONCLUSIONS:The therapeutic effect and improved quality of life for fecal incontinence is maintained 5 years after sacral nerve stimulation implantation and beyond. Device revision, replacement, or explant rate was acceptable, but future efforts should be aimed at improvement.</abstract><cop>Hagerstown, MDc</cop><pub>The ASCRS</pub><pmid>23303153</pmid><doi>10.1097/DCR.0b013e318276b24c</doi><tpages>12</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0012-3706 |
| ispartof | Diseases of the colon & rectum, 2013-02, Vol.56 (2), p.234-245 |
| issn | 0012-3706 1530-0358 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1285466870 |
| source | MEDLINE; Journals@Ovid Complete |
| subjects | Anal Canal - innervation Biological and medical sciences Chronic Disease Electric Stimulation Therapy - instrumentation Electric Stimulation Therapy - methods Electrodes, Implanted Fecal Incontinence - therapy Female Follow-Up Studies Gastroenterology. Liver. Pancreas. Abdomen Humans Male Medical sciences Other diseases. Semiology Quality of Life Sacrum - innervation Stomach. Duodenum. Small intestine. Colon. Rectum. Anus Surveys and Questionnaires Treatment Outcome |
| title | Long-term Durability of Sacral Nerve Stimulation Therapy for Chronic Fecal Incontinence |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-31T08%3A51%3A39IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Long-term%20Durability%20of%20Sacral%20Nerve%20Stimulation%20Therapy%20for%20Chronic%20Fecal%20Incontinence&rft.jtitle=Diseases%20of%20the%20colon%20&%20rectum&rft.au=Hull,%20Tracy&rft.aucorp=SNS%20Study%20Group&rft.date=2013-02&rft.volume=56&rft.issue=2&rft.spage=234&rft.epage=245&rft.pages=234-245&rft.issn=0012-3706&rft.eissn=1530-0358&rft.coden=DICRAG&rft_id=info:doi/10.1097/DCR.0b013e318276b24c&rft_dat=%3Cproquest_cross%3E1285466870%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1285466870&rft_id=info:pmid/23303153&rfr_iscdi=true |