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Sacral nerve stimulation for fecal incontinence: external anal sphincter defect vs. intact anal sphincter.
Dis Colon Rectum. 2008 Jul; 51(7):1015-24; discussion 1024-5.DC

Abstract

PURPOSE

This prospective study was designed to assess the effectiveness of sacral nerve stimulation for fecal incontinence in patients with external anal sphincter defect and to evaluate its efficacy regarding presence and size of sphincter defect.

METHODS

Fifty-three consecutive patients who underwent sacral nerve stimulation for fecal incontinence were divided into two groups: external anal sphincter defect group (n = 21) vs. intact sphincter group (n = 32). Follow-up was performed at 3, 6, and 12 months with anorectal physiology, Wexner's score, bowel diary, and quality of life questionnaires.

RESULTS

The external anal sphincter defect group (defect <90 degrees:defect 90 degrees-120 degrees = 11:10) and intact sphincter group were comparable with regard to age (mean, 63 vs. 63.6) and sex. Incidence of internal anal sphincter defect and pudendal neuropathy was similar. All 53 patients benefited from sacral nerve stimulation. Weekly incontinent episodes decreased from 13.8 to 5 (P < 0.0001) for patients with external anal sphincter defects and from 6.7 to 2 (P = 0.001) for patients with intact sphincter at 12-month follow-up. Quality of life scores improved in both groups (P < 0.0125). There was no significant difference in improvement in functional outcomes after sacral nerve stimulation between patients with or without external anal sphincter defects. Clinical benefit of sacral nerve stimulation was similar among patients with external anal sphincter defects, irrespective of its size. Presence of pudendal neuropathy did not affect outcome of neurostimulation.

CONCLUSIONS

Sacral nerve stimulation for fecal incontinence is as effective in patients with external anal sphincter defects as those with intact sphincter and the result is similar for defect size up to 120 degrees of circumference.

Authors+Show Affiliations

Department of Colorectal Surgery, Epworth Hospital, University of Melbourne, Melbourne, Australia. mirchan@hotmail.comNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

18484136

Citation

Chan, Miranda K Y., and Joe J. Tjandra. "Sacral Nerve Stimulation for Fecal Incontinence: External Anal Sphincter Defect Vs. Intact Anal Sphincter." Diseases of the Colon and Rectum, vol. 51, no. 7, 2008, pp. 1015-24; discussion 1024-5.
Chan MK, Tjandra JJ. Sacral nerve stimulation for fecal incontinence: external anal sphincter defect vs. intact anal sphincter. Dis Colon Rectum. 2008;51(7):1015-24; discussion 1024-5.
Chan, M. K., & Tjandra, J. J. (2008). Sacral nerve stimulation for fecal incontinence: external anal sphincter defect vs. intact anal sphincter. Diseases of the Colon and Rectum, 51(7), 1015-24; discussion 1024-5. https://doi.org/10.1007/s10350-008-9326-0
Chan MK, Tjandra JJ. Sacral Nerve Stimulation for Fecal Incontinence: External Anal Sphincter Defect Vs. Intact Anal Sphincter. Dis Colon Rectum. 2008;51(7):1015-24; discussion 1024-5. PubMed PMID: 18484136.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Sacral nerve stimulation for fecal incontinence: external anal sphincter defect vs. intact anal sphincter. AU - Chan,Miranda K Y, AU - Tjandra,Joe J, Y1 - 2008/05/17/ PY - 2007/07/13/received PY - 2007/12/18/accepted PY - 2007/11/18/revised PY - 2008/5/20/pubmed PY - 2008/7/18/medline PY - 2008/5/20/entrez SP - 1015-24; discussion 1024-5 JF - Diseases of the colon and rectum JO - Dis Colon Rectum VL - 51 IS - 7 N2 - PURPOSE: This prospective study was designed to assess the effectiveness of sacral nerve stimulation for fecal incontinence in patients with external anal sphincter defect and to evaluate its efficacy regarding presence and size of sphincter defect. METHODS: Fifty-three consecutive patients who underwent sacral nerve stimulation for fecal incontinence were divided into two groups: external anal sphincter defect group (n = 21) vs. intact sphincter group (n = 32). Follow-up was performed at 3, 6, and 12 months with anorectal physiology, Wexner's score, bowel diary, and quality of life questionnaires. RESULTS: The external anal sphincter defect group (defect <90 degrees:defect 90 degrees-120 degrees = 11:10) and intact sphincter group were comparable with regard to age (mean, 63 vs. 63.6) and sex. Incidence of internal anal sphincter defect and pudendal neuropathy was similar. All 53 patients benefited from sacral nerve stimulation. Weekly incontinent episodes decreased from 13.8 to 5 (P < 0.0001) for patients with external anal sphincter defects and from 6.7 to 2 (P = 0.001) for patients with intact sphincter at 12-month follow-up. Quality of life scores improved in both groups (P < 0.0125). There was no significant difference in improvement in functional outcomes after sacral nerve stimulation between patients with or without external anal sphincter defects. Clinical benefit of sacral nerve stimulation was similar among patients with external anal sphincter defects, irrespective of its size. Presence of pudendal neuropathy did not affect outcome of neurostimulation. CONCLUSIONS: Sacral nerve stimulation for fecal incontinence is as effective in patients with external anal sphincter defects as those with intact sphincter and the result is similar for defect size up to 120 degrees of circumference. SN - 1530-0358 UR - https://www.unboundmedicine.com/medline/citation/18484136/Sacral_nerve_stimulation_for_fecal_incontinence:_external_anal_sphincter_defect_vs__intact_anal_sphincter_ L2 - http://link.springer.com/article/10.1007/s10350-008-9326-0 DB - PRIME DP - Unbound Medicine ER -