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PTH-256 Sns for faecal incontinence following cauda equina syndrome
  1. S Elzein1,
  2. C Hoh2,
  3. S Brown2,
  4. C Maxwell-Armstrong1
  1. 1General Surgery, Nottingham University Hospitals, Nottingham
  2. 2General Surgery, Sheffield Teaching Hospitals, Sheffield, UK

Abstract

Introduction Quada Equina Syndrome can have devastating consequences. Faecal incontinence (FI) is one of these consequences. It can limit the individual’s social interactions and freedom of movement. The management of this condition ranges from incontinence products through conservative measures to surgery and colostomy as a last resort.

We reviewed our management of faecalincontinence in patients with cauda equina syndrome.

Method The medical notes of all patients who have undergone sacral nerve stimulator (SNS) for FI as a result of cauda equina syndrome have been reviewed and data collected. This includes patients from Nottingham university hospitals and Sheffield teaching hospitals.

Results Seven patients with faecal incontinence as a result of cauda equina syndrome and one with spina-bifida have been treated in the 2 specialist centres in the UK.

M:F 5:3. Median age is 38 years (31–64).

One female patient did not attend multiple outpatient appointments and has therefore been discharged back to the care of her GP prior to treatment.

As would be expected from the underlying aetiology, all had intact internal and external sphincters.

All had failed conservative measures. One patient previously underwent PTNS to no avail.

All 7 patients underwent temporary wire placement as a day case procedure.

One (14.3%) patient developed a post-operative wound infection following the temporary wires insertion. They had to be removed and replaced.

Six (85.7%) patient pertained >50% improvement in function with the SNS implant. In one patient it resulted in 10% improvement, however the patient was insistent that it has made a great and positive impact on his quality of life.

Two (28.6%) patients developed complication following permanent SNS implant.

Conclusion SNS is an effective and relatively safe procedure for faecal incontinence following cauda equina syndrome. Our sample size is small but the results clearly demonstrate that SNS can work well in patients with cauda equina syndrome.

Disclosure of interest None Declared.

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