Sacral nerve stimulation for faecal incontinence: patient selection, service provision and operative technique.
Colorectal Dis
; 13(8): e187-95, 2011 Aug.
Article
em En
| MEDLINE
| ID: mdl-21689330
ABSTRACT
AIM:
Faecal incontinence is estimated to affect between 2 and 3% of Western adult populations. In recent years sacral nerve stimulation has become an important treatment modality, often as the first-line surgical therapy. The aim of this article was to review the current evidence regarding patient selection and surgical technique and to evaluate the logistics of providing a neurostimulation service.METHOD:
A Medline search was performed including the keywords and/or MeSH headings of sacral nerve stimulation, neuromodulation, artificial pacemaker, faecal incontinence, patient selection, predictive factors and anal canal. Further studies were identified by cross-referencing from relevant articles and by appraisal of recent peer-reviewed conference abstracts and proceedings.RESULTS:
Despite the success of sacral nerve stimulation for several pathophysiological causes of incontinence, case selection is of paramount importance. Sacral nerve stimulation should not be offered outside a multidisciplinary pelvic floor unit. Temporary evaluation using diary cards can lead to false positive and negative results. Adherence to a meticulous surgical technique, using low amplitude stimulation to guide lead placement, provides optimal clinical outcome.CONCLUSION:
The short-term outcome of sacral nerve stimulation is dependent on patient factors and operative technique. Despite this, specific preoperative predictive factors of treatment success have yet to be identified.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Canal Anal
/
Cuidados Pré-Operatórios
/
Terapia por Estimulação Elétrica
/
Incontinência Fecal
Tipo de estudo:
Prognostic_studies
Limite:
Humans
Idioma:
En
Revista:
Colorectal Dis
Ano de publicação:
2011
Tipo de documento:
Article