4.1 Article

Improvement in the quality of life of faecal incontinent patients after sacral root stimulation treatment

Journal

CIRUGIA ESPANOLA
Volume 89, Issue 9, Pages 581-587

Publisher

ELSEVIER ESPANA SLU
DOI: 10.1016/j.ciresp.2011.04.027

Keywords

Fecal incontinence; Neuromodulation; Quality of life; EuroQuol Neuroestimulation

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Introduction: Faecal incontinence (FI) is a highly prevalent disorder that severely affects the health related quality of life (HRQOL) of the patients who suffer from it. Neuromodulation is a minimally invasive treatment that has demonstrated its efficacy in the treatment of FI symptoms over the past 10 years. The aim of this study is to check whether there is an improvement in the quality of life, using EuroQuol (EQ-5D), in patients with faecal incontinence treated with sacral root neuromodulation. Methodology: An observational study with prospective recording of quality of life data, before and after, using the EQ-5D on a series of patients diagnosed with moderate to severe FI with a complete or repaired sphincter who had a definitive MEDTRONIC Interstim (R) 3023 implant after a subchronic stimulation phase with a good response. Results: The initial mean number of leaks was 3.1 +/- 1, and the final was 0.5 +/- 0.6. The mean number of escapes per week decreased to 2.6 escapes (CI 95%: 2.1-3.1) after the definitive implant of the sacral root stimulator (P<.001). The mean baseline health status score was 55.9 +/- 13, and after neuromodulation it was 63.1 +/- 13. Thus, the visual analogue scale score increased by 7.1 points (CI 95%: 0.37-14) after the definitive implant of the sacral root stimulator (P<.05). In the HRQOL variables studied with the EQ-5D questionnaire, we found an improvement with neuromodulation in the mobility and the presence of anxiety and/or depression variables. On the other hand we found an improvement with the neurostimulator implant, which was not significant, in personal care, performing daily activities and the presence of pain and/or discomfort. The current health was better in 11 patients (57.9%), the same in 7 (36.8%) and worse in 1 (5.3%). Conclusions: Neuromodulation is a therapy that has demonstrated a significant improvement in HRQOL measured with the EQ-5D. (C) 2011 AEC. Published by Elsevier Espana, S.L. All rights reserved.

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