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Autonomous and Rechargeable Microneurostimulator Endoscopically Implantable into the Submucosa

Autonomous and Rechargeable Microneurostimulator Endoscopically Implantable into the Submucosa

Published on: September 27, 2018

Programming InterStim for faecal incontinence.

K R Cattle¹, L Douglas, E S Kiff

¹Department of General Surgery, University Hospital of South Manchester NHS Foundation Trust, Wythenshawe Hospital, Manchester, UK. kirstymcdowell@doctors.org.uk

Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland

|July 16, 2008

Summary

The most effective sacral nerve stimulation (SNS) program for fecal incontinence (FI) was not the most frequently used or longest-lasting. Re-programming was associated with higher symptom severity scores in patients undergoing SNS therapy.

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Area of Science:

Neuroscience
Gastroenterology
Urology

Background:

Sacral nerve stimulation (SNS) is a treatment for fecal incontinence (FI).
It involves implanting a pulse generator connected to a lead with programmable electrodes.
The 'ideal' programming strategy for SNS in FI is not well-established.

Purpose of the Study:

To determine if the 'ideal' SNS program for FI is most commonly used.
To assess if re-programming affects symptom severity scores in FI patients.

Main Methods:

Retrospective analysis of a sacral nerve stimulation patient database.
Extracted data included program usage frequency, duration of effectiveness, time to program initiation, and symptom severity scores.
Compared outcomes between patients with and without program changes.

Main Results:

The 'ideal' SNS program was not the most frequently used or effective long-term.
Commonly used programs demonstrated longer effectiveness.
Patients requiring re-programming had significantly higher symptom severity scores.
Lead migration was suggested by the delayed use of the electrode furthest from the tip.

Conclusions:

The 'ideal' SNS program for FI is not consistently applied or the most effective in practice.
Lead migration may influence programming needs over time.
Perianal sensation from SNS correlates with lower symptom scores and fewer re-programming needs.