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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
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.
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.
