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The effect of the number of active electrode poles during tined lead placement on long-term efficacy of sacral neuromodulation in patients with faecal incontinence.
Colorectal Dis. 2020 Jun 27 [Online ahead of print]CD

Abstract

AIM

There is an ongoing debate as to whether or not the efficacy of sacral neuromodulation (SNM) is optimized by maximizing the total number of active electrode poles (AEPs) during lead placement because there are more programming options. However, this is at the cost of increased operating time. The aims of this study were to establish if a higher number of AEPs improves SNM efficacy during the trial period and after permanent implantable pulse generator (IPG) placement and if there is there a correlation between number of AEPs and battery life of the first placed IPG.

METHOD

This was a single centre retrospective cohort study of new patients with faecal incontinence who underwent SNM between 2000 and 2018. Exclusion criteria were sphincter defect > 30%, rectocele/enterocele Grade 3 or higher and incomplete records.

RESULTS

In all, 288/456 (63%) patients (women 91%; mean age 58.5 ± 11.7 years) were eligible for analysis. The number of AEPs during lead placement was two (n = 42, 14.5%), three (n = 82, 28.5%) and four (n = 164, 57%). There was no association between the number of AEPs during tined lead placement and long-term efficacy. Neither the success rate of the trial phase nor the battery life after first placed IPG was influenced by the number of AEPs.

CONCLUSION

In this study, the number of AEPs does not seem to influence long-term efficacy of SNM success rate during the trial phase or the battery life of the first placed IPG. However, we also suggest that at the very least there should be two AEPs at lead placement.

Authors+Show Affiliations

Department of Surgery and Colorectal Surgery, Academic Hospital Maastricht, Maastricht University Medical Center, Maastricht, The Netherlands.Department of Surgery and Colorectal Surgery, Academic Hospital Maastricht, Maastricht University Medical Center, Maastricht, The Netherlands.Maastricht University, Maastricht, The Netherlands.Department of Surgery and Colorectal Surgery, Academic Hospital Maastricht, Maastricht University Medical Center, Maastricht, The Netherlands.Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Centre, Maastricht, The Netherlands.Department of Surgery and Colorectal Surgery, Academic Hospital Maastricht, Maastricht University Medical Center, Maastricht, The Netherlands.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32593211

Citation

Assmann, R, et al. "The Effect of the Number of Active Electrode Poles During Tined Lead Placement On Long-term Efficacy of Sacral Neuromodulation in Patients With Faecal Incontinence." Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland, 2020.
Assmann R, Breukink SO, Caubergh SAP, et al. The effect of the number of active electrode poles during tined lead placement on long-term efficacy of sacral neuromodulation in patients with faecal incontinence. Colorectal Dis. 2020.
Assmann, R., Breukink, S. O., Caubergh, S. A. P., Stassen, L. P. S., van Kuijk, S. M. J., & Melenhorst, J. (2020). The effect of the number of active electrode poles during tined lead placement on long-term efficacy of sacral neuromodulation in patients with faecal incontinence. Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland. https://doi.org/10.1111/codi.15223
Assmann R, et al. The Effect of the Number of Active Electrode Poles During Tined Lead Placement On Long-term Efficacy of Sacral Neuromodulation in Patients With Faecal Incontinence. Colorectal Dis. 2020 Jun 27; PubMed PMID: 32593211.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The effect of the number of active electrode poles during tined lead placement on long-term efficacy of sacral neuromodulation in patients with faecal incontinence. AU - Assmann,R, AU - Breukink,S O, AU - Caubergh,S A P, AU - Stassen,L P S, AU - van Kuijk,S M J, AU - Melenhorst,J, Y1 - 2020/06/27/ PY - 2020/03/18/received PY - 2020/05/20/accepted PY - 2020/6/28/pubmed PY - 2020/6/28/medline PY - 2020/6/28/entrez KW - Sacral neuromodulation KW - faecal incontinence KW - surgery KW - tined lead placement JF - Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland JO - Colorectal Dis N2 - AIM: There is an ongoing debate as to whether or not the efficacy of sacral neuromodulation (SNM) is optimized by maximizing the total number of active electrode poles (AEPs) during lead placement because there are more programming options. However, this is at the cost of increased operating time. The aims of this study were to establish if a higher number of AEPs improves SNM efficacy during the trial period and after permanent implantable pulse generator (IPG) placement and if there is there a correlation between number of AEPs and battery life of the first placed IPG. METHOD: This was a single centre retrospective cohort study of new patients with faecal incontinence who underwent SNM between 2000 and 2018. Exclusion criteria were sphincter defect > 30%, rectocele/enterocele Grade 3 or higher and incomplete records. RESULTS: In all, 288/456 (63%) patients (women 91%; mean age 58.5 ± 11.7 years) were eligible for analysis. The number of AEPs during lead placement was two (n = 42, 14.5%), three (n = 82, 28.5%) and four (n = 164, 57%). There was no association between the number of AEPs during tined lead placement and long-term efficacy. Neither the success rate of the trial phase nor the battery life after first placed IPG was influenced by the number of AEPs. CONCLUSION: In this study, the number of AEPs does not seem to influence long-term efficacy of SNM success rate during the trial phase or the battery life of the first placed IPG. However, we also suggest that at the very least there should be two AEPs at lead placement. SN - 1463-1318 UR - https://www.unboundmedicine.com/medline/citation/32593211/The_effect_of_the_number_of_active_electrode_poles_during_tined_lead_placement_on_long-term_efficacy_of_sacral_neuromodulation_in_patients_with_faecal_incontinence L2 - https://doi.org/10.1111/codi.15223 DB - PRIME DP - Unbound Medicine ER -
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