Introduction There is a paucity of data related to the outcome of sacral neurostimulation (SNS) device re-implantation for faecal incontinence (FI). This study aimed to determine the outcomes of re-implantation of SNS for FI.
Method An IRB approved retrospective review of prospectively collected data of patients with FI receiving SNS was performed. Demographic variables, co-morbidities, operative details, reportable events, and functional outcomes were analysed. Continuous variables were assessed for Gaussian distribution. Non-parametric variables were compared with the Mann-Whitney test, and normally distributed variables were compared with an independent samples t-test. In assessing the role of each intervention in decreasing FI score (FIS) comparatively, an analysis of covariance was performed (ANCOVA).
Results 115 patients (mean age 58.5 ± 15 years, 98 females) had implantation of SNS device from 2010–2014. 13% (15/115) underwent lead re-implantation. Implanted and re-implanted groups had similar demographics, co-morbidities, complication, and explantation rates. Operative time was significantly higher in the re-implanted group (first implanted 56.7 ± 17 min; re-implanted 70.1 ± 33 min; p = 0.01). Most common reason for re-implantation was lead-related in 33% (5/15). Loss of efficacy was identified in 20% (3/15) as was lack of efficacy 20% (3/15). Infection was observed in 20% (3/15) of patients, all of whom failed antibiotic therapy and were explanted. A significant decrease in FIS was seen in patients with a first time implantation (median FIS 16 to 7; p < 0.001), and re-implanted patients (median FIS 18 to 12.5; p = 0.036). There was an identifiable difference in preoperative FIS between groups (median FIS implanted 16, re-implanted 18; p = 0.036). ANCOVA analysis did not reveal superiority of either procedure in decreasing FIS (p = 0.284).
Conclusion Reimplantation of SNS is feasible and has similar outcomes as first time implantation. Failure and explantation of SNS should not preclude subsequent reimplantation.
Disclosure of interest None Declared.