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Sacral nerve stimulation for constipation: do we still miss something? Role of psychological evaluation
Alfonso Carriero1, Jacopo Martellucci, Pasquale Talento
1Pelvic Floor Center, Hospital Franchini, Montecchio Emilia, Italy.
Introduction:
The aim of this study was to try to understand if psychological evaluation of patients candidate to sacral nerve stimulation (SNS) could be a potential selection criterion to identify those patients who could successfully respond to this treatment.
Materials And Methods:
From 2005 to 2007, 68 patients with slow transit constipation were identified, and all of them fulfill the selection criteria for the SNS treatment. The MMPI-2 test was purposed to all the patients. Wexner score, bowel movements, and SF36 were recorded in all the patients.
Results:
Twenty-three patients (33.8%) refused the psychological evaluation. Forty-five patients completed the test: only 13 patients (19.1%) had a score in the normal range of the scales of the MMPI-2 and were implanted with the temporary test for SNS. After the screening period, 11 patients (84.6%) reported more than 50% improvement of bowel movements per week and no need of laxatives, so they were definitively implanted. The mean follow-up period was 22 months (range 12-36). The mean number of bowel movements per week and Wexner score were significantly improved after 1 year (p < 0.001).
Conclusions:
A complete and accurate psychological evaluation could be very important in the selection of the patients with STC that could benefit from SNS.
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