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[CT-guided electrode placement for sacral nerve stimulation in the treatment of faecal incontinence (cSNS)]
1Abteilung Allgemein- und Viszeralchirurgie (Ärztlicher Direktor: Prof. Dr. Dr. U. T. Hopt), Chirurgische Universitätsklinik, Freiburg im Breisgau, Deutschland.
Background:
The sacral nerve stimulation (SNS) can be performed in the screening phase under local anaesthesia. Implantation of the tined-lead electrodes is usually performed in an inpatient setting under general anaesthesia. An outpatient procedure for both PNE and implantation of the electrodes offers decisive advantages with respect to the accuracy of electrode placement.
Materials And Methods:
From 2006 to 2011 a total of 51 patients was treated with SNS in an outpatient setting.
Results:
Of 51 patients having the PNE, in four patients the procedure could not successfully be completed. In 39 of the 47 patients screened, the testing was positive. Eight times the screening was negative. The functional results show a significant decline in the Cleveland scores from 14.9 to 6.4. The manometric resting pressure improved from 23.4 mmHg to 43.81 mmHg, the squeezing pressure improved from 42.2 mmHg to 76.12 mmHg. Due to patients' perception and according to the response on the stimulus, the electrodes were placed on the left in S4 11 times, 23 times in the left S3, 3 times in the right S3, once in the left S2 and once in the right S2.
Conclusion:
CT-guided electrode placement is safe for temporary (subchronic) and permanent (chronic) sacral nerve stimulation and provides a valuable means for placement of the stimulating material.
