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Sacral nerve stimulation—hidden costs (uncovered)

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Aim

The aim of this study is to determine the occurrence of surgical revision in a cohort of patients treated with sacral nerve stimulation (SNS) for faecal incontinence and constipation and to establish the types of procedures performed and indications for surgery.

Method

From the years 2002 to 2014, 125 patients were identified who had undergone permanent SNS therapy with 36 (28.8 %) patients requiring surgical intervention postimplantation. These cases were retrospectively reviewed (range of follow-up 1–99 months).

Results

Over a total of 1512 months of SNS treatment, 51 unplanned surgical procedures were required in 36 patients. At present, 48 procedures have been performed at an average of 2.6 years following implantation and three patients are awaiting surgery. Lead-related problems accounted for 30 (58.8 %) procedures at an average of 1.7 years affecting 22 patients. Battery and implantable pulse generator-related problems attributed to 13 procedures (25.5 %) in 12 patients at an average of 5.0 years. Battery depletion occurred in seven patients at an average of 5.4 years. Surgical revision was required to replace, remove, or resite various components of the SNS system. Indications for surgery included lead damage, pain and loss or lack of SNS efficacy. Explantation was warranted in six patients due to poor SNS efficacy, pain, infection and facilitation of a magnetic resonance imaging scan. This was performed at an average of 1.6 years.

Conclusion

A considerable proportion of patients treated with SNS therapy require surgical revision. These unplanned procedures are associated with substantial unexpected costs that financially burden SNS services.

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Authors and Affiliations

  1. Department of Colorectal Surgery, University Hospital of South Manchester NHS Trust, Manchester, UK

    M. Zeiton, James Nicholson, Karen Telford & Abhiram Sharma

  2. University of Manchester, Manchester, UK

    Sara Faily, James Nicholson, Karen Telford & Abhiram Sharma

  3. Department of Surgery, University Hospital of South Manchester and MAHSC, University of Manchester, Acute Block, Wythenshawe Hospital, Manchester, M239LT, UK

    Abhiram Sharma

Authors
  1. M. Zeiton
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  2. Sara Faily
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  3. James Nicholson
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  4. Karen Telford
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  5. Abhiram Sharma
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Correspondence to Abhiram Sharma.

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The authors have read and understood International Journal of Colorectal Disease policy on declaration of interests and declare that there are no conflicts of interest.

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Zeiton, M., Faily, S., Nicholson, J. et al. Sacral nerve stimulation—hidden costs (uncovered). Int J Colorectal Dis 31, 1005–1010 (2016). https://doi.org/10.1007/s00384-016-2512-y

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  • DOI: https://doi.org/10.1007/s00384-016-2512-y

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