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

  • Original Article
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International Journal of Colorectal Disease Aims and scope Submit manuscript

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 %.

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Contribution of each author

Jakob Duelund-Jakobsen was involved in contributing to the conception and design of the study; acquisition, analysis and interpretation of presented data and in drafting the article and gave final approval of the version to be published.

Paul-Antoine Lehur was involved in contributing to the conception and design of the study, selecting and managing the patients included in the French database and critically revising the article for important intellectual content and gave final approval of the version to be published.

Lilli Lundby was involved in contributing to the conception and design of the study, critically revising the article for important intellectual content and gave final approval of the version to be published.

Vincent Wyart was responsible for data management for the French database and gave final approval of the version to be published.

Søren Laurberg was involved in contributing to the conception and design of the study and critically revising the article for important intellectual content and gave final approval of the version to be published.

Steen Buntzen was involved in contributing to the conception and design of the study; acquisition, analysis and interpretation of presented data and in drafting the article and gave final approval of the version to be published.

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Authors and Affiliations

  1. Surgical Research Unit, Department of Surgery P, Aarhus University Hospital, Tage-Hansens Gade 2, 8000, Aarhus, C. Denmark

    Jakob Duelund-Jakobsen, Lilli Lundby, Søren Laurberg & Steen Buntzen

  2. Clinique Chirurgicale, Hôtel-Dieu, Institut des Maladies de l’Appareil Digestif (IMAD), 1 Place Alexis Ricordeau, 44093, Nantes Cedex, France

    Paul-Antoine Lehur & Vincent Wyart

Authors
  1. Jakob Duelund-Jakobsen
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  2. Paul-Antoine Lehur
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  3. Lilli Lundby
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  4. Vincent Wyart
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  5. Søren Laurberg
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  6. Steen Buntzen
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Corresponding author

Correspondence to Jakob Duelund-Jakobsen.

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Financial disclosure

All authors have received honoraria from Medtronic as speakers at meetings and/or as members of the medical advisory board. Medtronic sponsored the construction and yearly maintenance services of the database from which the data is extracted. The study design, analysis and reporting have been conducted without the influence of Medtronic.

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Meeting presentation

Oral presentation at the ESCP-2014 meeting in Barcelona, Spain.

What is new in this paper

This is the first paper from a common Sacral Nerve Stimulation prospective database (SNSPD) including all patients implanted due to bowel dysfunction in Aarhus, Denmark, and Nantes, France. The SNSPD holds longitudinal follow-up data. The SNSPD confirmed that SNS therapy is safe and effective in the management of faecal incontinence.

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Duelund-Jakobsen, J., Lehur, PA., Lundby, L. et al. Sacral nerve stimulation for faecal incontinence—efficacy confirmed from a two-centre prospectively maintained database. Int J Colorectal Dis 31, 421–428 (2016). https://doi.org/10.1007/s00384-015-2411-7

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  • DOI: https://doi.org/10.1007/s00384-015-2411-7

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