Sacral nerve stimulation for fecal incontinence related to obstetric anal sphincter damage.
Dis Colon Rectum
; 51(5): 531-7, 2008 May.
Article
em En
| MEDLINE
| ID: mdl-18301948
ABSTRACT
PURPOSE:
Sphincter repair is the standard treatment for fecal incontinence secondary to obstetric external anal sphincter damage; however, the results of this treatment deteriorate over time. Sacral nerve stimulation has become an established therapy for fecal incontinence in patients with intact sphincter muscles. This study investigated its efficacy as a treatment for patients with obstetric-related incontinence.METHODS:
Fecally incontinent patients with external sphincter defects who would normally have undergone overlapping sphincter repair as a primary or repeat procedure were included. Eight consecutive women (median age, 46 (range, 35-67) years) completed temporary screening; all eventually had permanent implantation.RESULTS:
Six of eight patients had improved continence at median follow-up of 26.5 (range, 6-40) months. Fecal incontinent episodes improved from 5.5 (range, 4.5-18) to 1.5 (range, 0-5.5) episodes per week (P = 0.0078). Urgency improved in five patients, with ability to defer defecation improving from a median of <1 (range, 0-5) minute to 1 to 5 (range, 1 to >15) minutes (P = 0.031, all 8 patients). There was no change in anal manometry or rectal sensation. There was significant improvement in lifestyle, coping/behavior, depression/self-perception, and embarrassment as measured by the American Society of Colon and Rectal Surgery fecal incontinence quality of life score.CONCLUSIONS:
Sacral nerve stimulation is potentially a safe and effective minimally invasive treatment for fecal incontinence in patients with de novo external anal sphincter defects or defects after unsuccessful previous external anal sphincter repair, although numbers remain small.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Canal Anal
/
Terapia por Estimulação Elétrica
/
Incontinência Fecal
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Complicações do Trabalho de Parto
/
Plexo Lombossacral
Tipo de estudo:
Etiology_studies
Limite:
Adult
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Aged
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Female
/
Humans
/
Middle aged
/
Pregnancy
Idioma:
En
Ano de publicação:
2008
Tipo de documento:
Article