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Dynamic Article: Permanent Sacral Nerve Stimulation Under Local Anesthesia: Feasibility, Best Practice, and Patient

Kim J Gorissen1, Alexander L A Bloemendaal, Siriluck Prapasrivorakul

  • 1Pelvic Floor Centre, Department of Colorectal Surgery, Churchill Hospital, Oxford University Hospitals, Oxford, United Kingdom.

Diseases of the Colon and Rectum
|November 7, 2015
PubMed
Summary

Permanent sacral nerve stimulation under local anesthesia is a safe and effective treatment for fecal incontinence, showing high success rates and patient satisfaction. This minimally invasive procedure offers significant logistical and financial benefits.

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Area of Science:

  • Urology
  • Gastroenterology
  • Neurology

Background:

  • Fecal incontinence incidence is rising, increasing healthcare burdens.
  • Sacral neuromodulation is a growing treatment option.
  • Local anesthesia implantation offers potential benefits.

Purpose of the Study:

  • Evaluate technical and clinical success of permanent sacral nerve stimulation under local anesthesia.
  • Assess complication rates and patient satisfaction.
  • Determine the safety and efficacy of the procedure.

Main Methods:

  • Cohort analysis of 61 patients undergoing sacral nerve stimulation for fecal incontinence over 1 year.
  • Procedures performed in a specialized pelvic floor unit.
  • Outcomes measured using Fecal Incontinence Severity Index, Fecal Incontinence Quality of Life scale, and Gastrointestinal Quality of Life Index.

Main Results:

  • High technical success rate with a median procedural time of 50 minutes.
  • Significant reduction in Fecal Incontinence Severity Index scores (37 to 27, p=0.001).
  • Marked improvement in quality of life scores (FIQLS and GIQLI) at 3 and 13 months.
  • 4.9% complication rate and no reported leg pain.

Conclusions:

  • Permanent sacral nerve stimulation under local anesthesia is technically and clinically successful.
  • The procedure is safe, well-tolerated, and offers logistical and financial advantages.
  • High patient satisfaction reported, with all recommending the procedure.