WESTPORT, CT (Reuters Health) Jun 04 - Permanent sacral nerve modulation resulted in a significant reduction in fecal incontinence in a select group of patients, according to data presented Monday at the annual meeting of the American Society of Colon and Rectal Surgeons in San Diego, California.
Dr. Ezio Ganio, of the University of Padova, in Rome, Italy, and colleagues performed sacral neuromodulation implants in 18 individuals (16 female) with fecal incontinence. The patients, who were a mean age of 58.6 years, had structurally intact external and internal anal sphincter, experienced fecal incontinence for solid or liquid stool at least once a week during the preceding 2 months, and had not responded to conventional behavioral or medical treatments, Dr. Ganio said.
In presurgical peripheral nerve evaluation of the patients, "we observed a decrease in the number of incontinence episodes for liquid and solid stools over 7 days from a mean of 5.5 episodes before the test to 1.5 [episodes post-test]," Dr. Ganio told Reuters Health. He noted that presurgical peripheral nerve evaluation offers the possibility to predict sacral neuromodulation results.
Dr. Ganio's group then implanted each patient with an electrode into the specific sacral foramen identified through peripheral nerve evaluation as having adequate motor and sensitive responses. Once fixed to the sacral periosteum Dr. Ganio explained, the electrodes were, "connected to an implantable pulse generator installed in a subcutaneous pouch in the abdominal wall or in the buttock."
Postsurgical incontinence episodes for liquid or solid stool over 14 days decreased to a mean of 2.1 at 3 months, 3.4 at 6 months, and 0.6 at 12 months of follow-up, Dr. Ganio said.
The investigators noted no early or late electrode displacements and no local sepsis or perioperative complications in these patients. Dr. Ganio noted that an electrode break in one patient resulted in loss of effectiveness, which was recovered following replacement of the electrode.
"Not all patients
are amenable for this treatment," Dr. Ganio said. However, "I feel that
sacral neuromodulation can be a further option in selected patients with
functional fecal incontinence."
2001 Reuters Ltd.