Patient Satisfaction With Long-term Sacral Neuromodulation for Fecal Incontinence: Experience From a Single Tertiary...

Area of Science:

• Urology
• Gastroenterology
• Pelvic Floor Disorders

Background:

• Sacral neuromodulation (SNM) is a proven long-term treatment for fecal incontinence.
• Treatment efficacy is traditionally measured by bowel diaries and symptom severity questionnaires, defining success as >50% improvement.
• Patient satisfaction offers a more individualized metric for treatment effectiveness.

Purpose of the Study:

• To evaluate long-term patient-reported satisfaction with sacral neuromodulation (SNM).
• To compare patient satisfaction with conventional efficacy measures for fecal incontinence.

Main Methods:

• Observational study utilizing a prospectively maintained database from a single tertiary pelvic floor referral unit.
• Data from 70 patients (median age 69 years, 11 years post-implantation) were analyzed.
• Patient satisfaction was assessed using a visual analog scale (0-100%), alongside bowel diaries and validated questionnaires (Manchester Health Questionnaire, St. Mark's Incontinence Score).

Main Results:

• Significantly higher satisfaction (75%) was reported in patients with active SNM devices compared to inactive ones (20%).
• No significant correlation was found between symptom improvement via conventional measures and patient satisfaction.
• High satisfaction (80%) was observed even when patients did not meet the >50% improvement threshold for "success."

Conclusions:

• High patient satisfaction is achievable with sacral neuromodulation for fecal incontinence.
• Initial response to percutaneous nerve evaluation may not predict long-term treatment satisfaction.
• Changes in quality-of-life measures and compensatory behaviors appear to correlate better with patient satisfaction.