Article Text

PDF
PTU-164 Factors associated with morbidity following sacral neurostimulation for faecal incontinence: beware of the high risk groups
  1. A Cracco1,
  2. S Chadi1,
  3. FG Rodrigues1,
  4. M Zutshi2,
  5. B Gurland2,
  6. SD Wexner1,
  7. G Dasilva1
  1. 1Colorectal Surgery, Cleveland Clinic Florida, Weston
  2. 2Colorectal Surgery, Cleveland Clinic, Cleveland, USA

Abstract

Introduction Sacral Neurostimulation (SNS) has become a preferred treatment for faecal incontinence (FI). The aim of this study was to identify the factors associated with morbidity following SNS for FI.

Method An IRB approved retrospective review of prospectively collected data of patients treated for FI with SNS was performed. Demographic variables, causes of FI and surgical details were correlated with the incidence of morbidity. Morbidity included pain, infection, noninfectious wound concerns, lead-related issues, loss and lack of efficacy. Categorical variables were analysed with Chi-squared analysis, whereas non-parametric variables were compared with the Mann Whitney U test. Significance was defined as a p-value less than 0.05.

Results 115 patients (mean age 58.5 ± 15 years, 85% females) underwent implantation of the device from 2010 to 2014 in one institution. The median follow-up was 8 (range 0.3–37) months. The most common morbidity was stimulation related pain (21.7%) whereas pain at the site of implantation occurred in 11.3% of patients. Furthermore a history of pain syndromes (p = 0.03) was found to be significantly associated with higher rates of stimulation-related pain whereas the only factor associated with pain at the site of implantation was male gender (p = 0.01). A loss of efficacy was observed in 16.5% of patients while other 7% of patients never derived significant benefit. A loss of efficacy was found to be significantly associated with a prior spinal surgery (p = 0.03). 15% (17/115) underwent explantation after first surgery, and 8% (9/115) had surgical revision, with 33% (3/9) requiring further explantation. 13% (15/115) underwent reimplantation with 20% (3/15) requiring explantation.

Conclusion There is minimal information on the rates of morbidity in patients with SNS procedures performed for FI. This study suggests that male gender, prior spinal surgery, and a history of pain syndromes were correlated with postoperative morbidity.

Disclosure of interest None Declared.

Statistics from Altmetric.com

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.