Dynamic Article: Percutaneous Nerve Evaluation Versus Staged Sacral Nerve Stimulation for Fecal Incontinence.
Dis Colon Rectum
; 59(10): 962-7, 2016 Oct.
Article
em En
| MEDLINE
| ID: mdl-27602927
ABSTRACT
BACKGROUND:
Sacral neuromodulation using a 2-staged approach is an established therapy for fecal incontinence. Office-based percutaneous nerve evaluation is a less-invasive alternative to the stage 1 procedure but is seldom used in the evaluation of patients with fecal incontinence.OBJECTIVE:
The aim of this study was to determine the clinical success of percutaneous nerve evaluation versus a staged approach.DESIGN:
This was a retrospective review of a prospectively maintained, single-institution database of patients treated with sacral neuromodulation for fecal incontinence. SETTINGS This study was conducted at a single academic medical center. PATIENTS Eighty-six consecutive patients were treated with sacral neuromodulation for fecal incontinence.INTERVENTIONS:
Percutaneous nerve evaluation was compared with a staged approach. MAIN OUTCOMEMEASURES:
The primary outcome measured was the proportion of patients progressing to complete implantation based on >50% improvement in Wexner score during the testing phase.RESULTS:
Percutaneous nerve evaluation was performed in 45 patients, whereas 41 underwent a staged approach. The mean baseline Wexner score did not differ between testing groups. Success was similar between the staged approach and percutaneous nerve evaluation (90.2% versus 82.2%; p = 0.36). The mean 3-month Wexner score was not significantly different between testing methods (4.4 versus 4.1; p = 0.74). However, infection was more likely to occur after the staged approach (10.5% versus 0.0%; p < 0.05).LIMITATIONS:
This study was limited by its retrospective nature and potential for selection bias.CONCLUSIONS:
Percutaneous nerve evaluation offers a viable alternative to a staged approach in the evaluation of patients for sacral neuromodulation in the setting of fecal incontinence. Not only are success rates similar, but percutaneous nerve evaluation also has the benefit of limiting patients to 1 operating room visit and has lower rates of infection as compared with the traditional staged approach for sacral neuromodulation.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Canal Anal
/
Qualidade de Vida
/
Terapia por Estimulação Elétrica
/
Incontinência Fecal
/
Plexo Lombossacral
Tipo de estudo:
Diagnostic_studies
/
Observational_studies
Limite:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
País como assunto:
America do norte
Idioma:
En
Ano de publicação:
2016
Tipo de documento:
Article