Quality of life and morbidity after permanent sacral nerve stimulation for fecal incontinence.

Details

Serval ID
serval:BIB_BB1BC36FC40F
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Quality of life and morbidity after permanent sacral nerve stimulation for fecal incontinence.
Journal
Archives of Surgery
Author(s)
Hetzer F.H., Hahnloser D., Clavien P.A., Demartines N.
ISSN
0004-0010 (Print)
ISSN-L
0004-0010
Publication state
Published
Issued date
2007
Volume
142
Number
1
Pages
8-13
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
HYPOTHESIS: Permanent sacral nerve stimulation (SNS) is a promising emerging treatment for fecal incontinence. However, there is little data on morbidity and quality of life (QOL) during long-term stimulation.
DESIGN: Prospective trial to assess morbidity and QOL in patients treated with SNS. Median follow-up was 13 months (range, 1-42 months).
SETTING: University hospital providing primary, secondary, and tertiary care.
PATIENTS: Between December 2001 and July 2005, SNS was tested in 44 patients (30 women), with a median age of 65 years (range, 15-88 years).
INTERVENTIONS: Percutaneous nerve evaluation and permanent insertion of an implantable pulse generator.
MAIN OUTCOME MEASURES: Morbidity, stool diary, and Wexner Score for fecal incontinence; Hanley Score for urinary incontinence; and Gastrointestinal Quality of Life Index, the 36-item short form health survey, and the Royal London Hospital questionnaire for QOL.
RESULTS: A permanent stimulator was implanted in 37 patients (84%). Eight patients (22%) experienced complications that required surgical intervention. (A successful restimulation was possible for 5 of those patients.) Adverse effects of SNS were remedied in 5 patients by reprogramming the stimulator. Wexner Scores decreased from a median of 16 points preoperatively (range, 6-20), to a median of 5 points postoperatively (range, 0-13; P<.001). The median number of involuntary stool losses and for urge defecations also decreased significantly. Significant improvement in QOL was found in both generic and incontinence-specific questionnaires (P<.05). The success rate of SNS was 77% (34 of 44 patients) and 92% (34 of 37) in patients with permanent implantation.
CONCLUSIONS: The minimally invasive technique of SNS is safe and effective. Most adverse effects can be easily remedied. Our data demonstrate that SNS significantly improves patients' QOL, including their physical and psychological well-being.
Keywords
Adolescent, Adult, Aged, Aged, 80 and over, Fecal Incontinence/surgery, Female, Health Status Indicators, Humans, Male, Middle Aged, Morbidity, Postoperative Period, Prostheses and Implants, Quality of Life, Surgical Procedures, Minimally Invasive, Treatment Outcome
Pubmed
Web of science
Open Access
Yes
Create date
28/01/2008 9:53
Last modification date
20/08/2019 16:29
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