Treatment of slow-transit constipation with sacral nerve modulation

Area of Science:

• Gastroenterology
• Neurology
• Surgical Innovation

Background:

• Constipation is a prevalent condition, posing significant challenges in treatment selection, particularly for slow-transit constipation (STC).
• Sacral nerve modulation (SNM) is an emerging therapeutic option for refractory constipation.

Purpose of the Study:

• To evaluate the efficacy and safety of sacral nerve modulation (SNM) as a treatment for patients diagnosed with slow-transit constipation (STC).

Main Methods:

• A retrospective analysis was conducted on patients with STC who received SNM treatment.
• Patient assessments included cinedefecography, colon transit-time, Cleveland Clinic Constipation Score (CCS), SF-36 Quality of Life (QoL) survey, and bowel diaries.
• A temporary SNM implant was used for a 4-week trial period, with success defined by the cessation of laxative/enema use and improved QoL.

Main Results:

• Out of fifteen STC patients treated, nine (60%) proceeded to permanent SNM implantation.
• Significant improvements were observed, with a mean reduction of 10 points in the Wexner Constipation Score (CCS) and a 6.2-point increase in Quality of Life (QoL) scores.
• The procedure was well-tolerated, with no reported complications during a mean follow-up of 42 months.

Conclusions:

• Sacral nerve modulation (SNM) demonstrates potential as a valuable therapeutic intervention for managing slow-transit constipation (STC).
• SNM offers a safe and effective alternative for patients with STC refractory to conventional treatments.