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Comparison of long-term outcome of sacral nerve stimulation for constipation and faecal incontinence with focus on explantation rate, additional visits, and patient satisfaction

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Abstract

Background

The aim of the present study was to compare sacral nerve stimulation (SNS) for constipation (SNS-C) with SNS for idiopathic faecal incontinence (SNS-IFI) regarding explantation rate, additional visits, and improvement of patient satisfaction 5 years after implantation.

Methods

From our prospective database (launched in 2009), we extracted all SNS-C patients 5 years post-implantation, and the SNS-IFI patients implanted just before and just after each SNS-C patient. We retrospectively evaluated the explantation rate, number of additional visits, and patient satisfaction using a visual analogue scale (VAS). We hypothesized that compared with those in the SNS-IFI group: (1) the explantation rate would be higher in SNS-C patients, (2) the number of additional visits would be higher in SNS-C patients, and (3) in patients with an active implant at 5 years, the improvement in VAS would be the same.

Results

We included 40 SNS-C patients and 80 SNS-IFI patients. In the SNS-C group 7/40 (17.5%), patients were explanted, compared to 10/80 (12.5%) patients in the SNS-IFI group (p = 0.56). The mean number of additional visits in the SNS-C group was 3.5 (95% CI 2.8–4.1)) and 3.0 (95% CI 2.6–3.6)) in the SNS-IFI group (p = 0.38). Additional visits due to loss of efficacy were significantly higher in the SNS-C patients (p = 0.03). The reduction in VAS score (delta VAS) at 5 years was 37.1 (95% CI 20.9–53.3) in the SNS-C group, and 46.0 (95% CI 37.9–54.0) in the SNS-IFI group (p = 0.27).

Conclusions

No significant difference was found regarding explantation rate, number of additional visits, or improvement of VAS at 5 years after SNS implantation between SNS-C patients and SNS-IFI patients.

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Acknowledgements

LL, SL and JDJ have received honorarium 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.

Funding

This study was conducted as a part of routine clinical work and no funding was received. Medtronic sponsored the construction and yearly maintenance services of the database from which the data were extracted. The study design, analysis, and reporting were conducted without the influence of Medtronic. The corresponding author had full access to all data in the study and had final responsibility for the decision to submit for publication.

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Authors and Affiliations

  1. Department of Surgery, Aarhus University Hospital, Palle Juul-Jensens, Boulevard 99, 8200, Aarhus N, Denmark

    J. Hidaka, L. Lundby, S. Laurberg & J. Duelund-Jakobsen

  2. Hidaka Coloproctology Clinic, Kurume, Japan

    J. Hidaka

Authors
  1. J. Hidaka
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  2. L. Lundby
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  3. S. Laurberg
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  4. J. Duelund-Jakobsen
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Contributions

SL and JDJ were responsible for the study concept and design. LL and JDJ acquired and monitored the data. JH and JDJ did the statistical analysis and JH and JDJ drafted the manuscript and analysed and interpreted the data. All authors revised the manuscript for important intellectual content. JDJ was the principal investigator.

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Correspondence to J. Hidaka.

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No ethical approval was needed according to Danish law.

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All patients were informed of the database content.

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Hidaka, J., Lundby, L., Laurberg, S. et al. Comparison of long-term outcome of sacral nerve stimulation for constipation and faecal incontinence with focus on explantation rate, additional visits, and patient satisfaction. Tech Coloproctol 24, 1189–1195 (2020). https://doi.org/10.1007/s10151-020-02328-0

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  • DOI: https://doi.org/10.1007/s10151-020-02328-0

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