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Published on: April 25, 2017
Clinical Efficacy of Sacral Neuromodulation for Fecal Incontinence Across Multiple Etiologies: A Single-Center Study
Peirui Wu1, Tianming Ma2, Qinxian Huang3
1Department of General Surgery (Colorectal Surgery), The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China; Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China; Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
Objective:
This study aimed to evaluate the clinical outcomes of sacral neuromodulation (SNM) for fecal incontinence (FI) caused by diverse etiologies.
Materials And Methods:
This retrospective study, conducted between April 2021 and December 2024, analyzed 34 consecutive patients with FI who underwent SNM. Preoperative examinations included high-resolution anorectal manometry, magnetic resonance imaging, and endoscopy. Symptom severity was assessed using the Wexner or low anterior resection syndrome (LARS) score, and quality of life was evaluated using the Fecal Incontinence Quality of Life scores (FIQL) pre- and postoperatively.
Results:
The cohort included 14 women and 20 men with a median age of 52 years and a median FI duration of five years. Etiologies included LARS (n = 11), neurogenic bowel (n = 9), congenital malformations (n = 5), idiopathic FI (n = 3), and trauma- or radiation-related FI (n = 6). After successful lead implantation, >50% symptom relief was achieved in 29 patients (85.3%) during the testing phase, and 27 patients (79.4%) subsequently underwent permanent implantable pulse generator implantation. During a median follow-up of 32 months, Wexner scores decreased significantly from baseline (18.1 ± 2.3) to 6.6 ± 5.4 (testing phase), 5.3 ± 2.7 (six months), 8.8 ± 2.6 (12 months), and 8.2 ± 1.5 (24 months) (all p < 0.001). Significant improvements also were observed in the FIQL domains for lifestyle, coping/behavior, and depression (p < 0.05), whereas the embarrassment domain remained unchanged. Reported complications included surgical site infections (n = 2), delayed wound healing (n = 1), and one case of late efficacy that was successfully managed with device revision.
Conclusion:
SNM provides safe, effective, and sustained relief in symptoms and improvements in quality of life for patients with FI across a spectrum of complex etiologies.
Clinical Trial Registration:
The Chinese Clinical Trial Registry registration number for the study is ChiCTR2100054268.
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