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Five-year single center experience of sacral neuromodulation for isolated fecal incontinence or fecal incontinence combined with low anterior resection syndrome

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Abstract

Purpose

Sacral neuromodulation (SNM) has proven to be a safe and effective treatment for fecal incontinence (FI). For low anterior resection syndrome (LARS), however, SNM efficacy is still poorly documented. The primary aim of this study was to report on efficacy of SNM therapy for patients with isolated FI or LARS. Furthermore, we evaluated the safety of the procedure and the relevance of adequate follow-up.

Methods

A retrospective analysis was performed upon a prospectively maintained database of all patients who underwent SNM therapy for isolated FI or LARS between January 2014 and January 2019. The Wexner and LARS scores were evaluated at baseline, during test phase, after definitive implantation and annually during follow-up. Treatment success was defined as at least 50% improvement of the Wexner score or a reduction to minor or no LARS.

Results

Out of 89 patients with isolated FI or LARS who had a SNM test phase, 62 patients were eligible for implantation of the permanent SNM device. At baseline, 3 weeks, and 1, 2, 3, 4 and 5 years after definitive implantation the median Wexner score of all patients was 18, 2, 4.5, 5, 5, 4 and 4.5, respectively, and 18, 4, 5.5, 5, 4, 3 and 4, respectively, for patients with FI and LARS. Patients with LARS more frequently required changes in program settings.

Conclusions

SNM therapy is a safe and effective treatment for patients with isolated FI and patients with FI and LARS. Adequate follow-up is essential to ensure long-term effectivity, especially for LARS patients.

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Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Digestive and Hepatobiliary/Pancreatic Surgery, Groeninge Hospital, President Kennedylaan 4, 8500, Kortrijk, Belgium

    C. De Meyere, F. Nuytens & M. D’Hondt

  2. Department of Oncology and Statistics, Groeninge Hospital, Kortrijk, Belgium

    I. Parmentier

Authors
  1. C. De Meyere
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  2. F. Nuytens
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  3. I. Parmentier
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  4. M. D’Hondt
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Contributions

All the authors meet the ICMJE authorship criteria, with the following specified contributions: CDM: study design, data acquisition and data interpretation. FN: data interpretation. IP: data analysis. MD: study design and data interpretation.

Corresponding author

Correspondence to M. D’Hondt.

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Conflict of interest

None of the authors have potential and real conflicts of interest.

Ethical approval

All procedures performed were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study protocol was approved by the ethics committee at the investigational site (B396201939298).

Informed consent

A written informed consent concerning the inclusion in the database was obtained from every patient.

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De Meyere, C., Nuytens, F., Parmentier, I. et al. Five-year single center experience of sacral neuromodulation for isolated fecal incontinence or fecal incontinence combined with low anterior resection syndrome. Tech Coloproctol 24, 947–958 (2020). https://doi.org/10.1007/s10151-020-02245-2

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  • DOI: https://doi.org/10.1007/s10151-020-02245-2

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