Sacral Nerve Stimulation Fails to Offer Long-term Benefit in Patients With Slow-Transit Constipation

Area of Science:

• Gastroenterology
• Colorectal Surgery
• Neuromodulation

Background:

• Sacral nerve stimulation (SNS) is explored for treating slow-transit constipation (STC).
• A prior randomized controlled trial (RCT) found no significant therapeutic benefit of SNS over sham stimulation in STC patients.
• Long-term outcomes of these patients following the initial RCT warrant further investigation.

Purpose of the Study:

• To evaluate the long-term efficacy of sacral nerve stimulation (SNS) in patients diagnosed with scintigraphically confirmed slow-transit constipation (STC).

Main Methods:

• This study involved long-term follow-up of patients previously enrolled in a randomized controlled trial (RCT).
• The study was conducted at an academic tertiary public hospital.
• Primary outcome was complete evacuation frequency; secondary outcome was colonic transit time at 1 year.

Main Results:

• Fifty-three patients entered long-term follow-up; 44 withdrew due to treatment failure or adverse events.
• At 1 and 2 years, only 18.8% and 5.7% of patients, respectively, met the primary outcome of improved evacuation.
• Colonic transit time did not significantly improve at 1-year follow-up compared to baseline.

Conclusions:

• Sacral nerve stimulation (SNS) demonstrated no long-term therapeutic benefit for patients with slow-transit constipation (STC).
• High rates of treatment failure and adverse events suggest SNS is not an effective treatment for this condition.
• Further research may explore alternative therapeutic strategies for STC.