Journal
INTERNATIONAL JOURNAL OF COLORECTAL DISEASE
Volume 26, Issue 12, Pages 1583-1587Publisher
SPRINGER
DOI: 10.1007/s00384-011-1257-x
Keywords
Sacral neuromodulation; Sacral nerve stimulation; Constipation
Categories
Ask authors/readers for more resources
Background Constipation is a common multifactorial gastrointestinal symptom with quality of life implications. Sacral neuromodulation has been used in the management of severe constipation with mixed results. The aim of this study was to review our experience of sacral neuromodulation as a treatment for chronic constipation and develop a chronic constipation management protocol. Methods In patients with severe constipation, failure of conservative management including biofeedback and rectal irrigation were considered for neuromodulation. Temporary stimulation lead was placed in the sacral foramen of eligible patients and pre and post stimulation bowel diaries were compared. Patients with a parts per thousand yen50% improvement in bowel diaries had permanent implant. Patients were followed up at 2 and 4 weeks, 3, 6, and 12 months, and then yearly with bowel diaries. Results Temporary neuromodulation wires were implanted in 21 patients (20 female). Significant bowel diary improvement was seen in 12 (57%) patients (p < 0.01). Eleven permanent implants have been performed. Improvement in symptoms was lost in one patient. No major side effects were observed. Three patients have had reoperations (one wire fracture, one reposition of battery, and one poor initial lead placement). Improvements in bowel diaries have been maintained over a median follow-up period of 38 months (18-62 months). Conclusion Sacral neuromodulation can provide long-term symptom relief in selected patients with severe constipation. Sacral neuromodulation should be incorporated into the treatment algorithm for chronic constipation.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available