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Related Experiment Video

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Technical and functional outcome after sacral neuromodulation using the "H" technique.

Mohammad Mahdi Kasiri1, Martina Mittlboeck2, Christopher Dawoud1

  • 1Division of General Surgery, Department of Surgery, Medical University of Vienna/AKH, Waehringer Guertel 18-20, 1090, Vienna, Austria.

Wiener Klinische Wochenschrift
|December 6, 2022
PubMed
Summary

The H technique for sacral neuromodulation (SNM) is technically feasible and effective for treating constipation and fecal incontinence (FI). This method shows promising medium-term results, improving quality of life for many patients.

Keywords:
ConstipationFecal incontinenceH techniqueInterStimNeurostimulation

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Area of Science:

  • Urology
  • Gastroenterology
  • Neurology

Background:

  • Sacral neuromodulation (SNM) is a standard treatment for pelvic floor disorders like constipation and fecal incontinence (FI).
  • The H technique, a standardized electrode placement method, was introduced in 2017 to improve SNM outcomes.
  • Investigating the feasibility and functional results of the H technique is crucial for optimizing patient care.

Purpose of the Study:

  • To assess the technical feasibility of the H technique for SNM implantation.
  • To evaluate the functional outcomes and quality of life improvements in patients undergoing SNM via the H technique.
  • To identify factors associated with postoperative complications and success rates.

Main Methods:

  • A prospective study of 50 patients who underwent SNM using the H technique between 2017 and 2020.
  • Collection of demographic and clinical data, with a 40-month follow-up period.
  • Prospective monitoring of functional outcomes using standardized questionnaires and assessment of quality of life.

Main Results:

  • 72% of patients achieved >50% symptom relief and received permanent SNM implants.
  • Successful relief rates were 75% for FI and 64% for constipation.
  • Significant improvements were observed in quality of life, Vaizey scores, and ODS scores (p < 0.01); 10% of patients experienced complications, with male gender associated with increased risk.

Conclusions:

  • The H technique for SNM implantation is technically feasible and effective for treating FI and constipation.
  • Medium-term results demonstrate significant symptom relief and improved quality of life.
  • Male patients and those with BMI > 25 are at higher risk for perioperative complications.