Effectiveness of sacral nerve stimulation in fecal incontinence after multimodal oncologic treatment for pelvic malignancies: a multicenter study with 2-year follow-up

2018 ◽  
Vol 22 (2) ◽  
pp. 97-105 ◽  
Author(s):  
M. Schiano di Visconte ◽  
G. A. Santoro ◽  
N. Cracco ◽  
G. Sarzo ◽  
G. Bellio ◽  
...  
Keyword(s):  
Fecal Incontinence ◽  
Multicenter Study ◽  
Nerve Stimulation ◽  
Sacral Nerve Stimulation ◽  
Sacral Nerve ◽  
Pelvic Malignancies ◽  
Oncologic Treatment

Sacral Nerve Stimulation for Fecal Incontinence Following Surgery for Rectal Prolapse Repair: A Multicenter Study

2005 ◽  
Vol 48 (6) ◽  
pp. 1243-1248 ◽  
Author(s):  
Michael E. D. Jarrett ◽  
Klaus E. Matzel ◽  
Michael Stösser ◽  
Cor G. M. I. Baeten ◽  
Michael A. Kamm
Keyword(s):  
Fecal Incontinence ◽  
Rectal Prolapse ◽  
Multicenter Study ◽  
Nerve Stimulation ◽  
Sacral Nerve Stimulation ◽  
Prolapse Repair ◽  
Sacral Nerve

scholarly journals Sacral nerve stimulation in patients with ileal pouch-anal anastomosis

2021 ◽  
Author(s):  
C. Seifarth ◽  
N. Slavova ◽  
C. Degro ◽  
K. S. Lehmann ◽  
M. E. Kreis ◽  
...  
Keyword(s):  
Fecal Incontinence ◽  
Nerve Stimulation ◽  
Sacral Nerve Stimulation ◽  
Ileal Pouch ◽  
Functional Results ◽  
Stool Frequency ◽  
Ileostomy Closure ◽  
Sacral Nerve ◽  
Anal Anastomosis

Abstract Purpose Functional results after proctocolectomy and ileal pouch-anal anastomosis (IPAA) are generally good. However, some patients suffer from high stool frequency or fecal incontinence. Sacral nerve stimulation (SNS) may represent a therapeutic alternative in these patients, but little is known about indication and results. The aim of this study was to evaluate incontinence after IPAA and demonstrate SNS feasibility in these patients. Methods This retrospective study includes patients who received a SNS between 1993 and 2020 for increased stool frequency or fecal incontinence after proctocolectomy with IPAA for ulcerative colitis. Proctocolectomy was performed in a two- or three-step approach with ileostomy closure as the last step. Demographic, follow-up data and functional results were obtained from the hospital database. Results SNS was performed in 23 patients. Median follow-up time after SNS was 6.5 years (min. 4.2–max. 8.8). Two patients were lost to follow-up. The median time from ileostomy closure to SNS implantation was 6 years (min. 0.5–max. 14.5). Continence after SNS improved in 16 patients (69%) with a median St. Marks score for anal incontinence of 19 (min. 4–max. 22) before SNS compared to 4 (0–10) after SNS placement (p = 0.012). In seven patients, SNS therapy was not successful. Conclusion SNS implantation improves symptoms in over two-thirds of patients suffering from high stool frequency or fecal incontinence after proctocolectomy with IPAA. Awareness of the beneficial effects of SNS should be increased in physicians involved in the management of these patients.

scholarly journals Sacral nerve stimulation with appropriate parameters improves constipation in rats by enhancing colon motility mediated via the autonomic-cholinergic mechanisms

2019 ◽  
Vol 317 (5) ◽  
pp. G609-G617 ◽  
Author(s):  
Zhihui Huang ◽  
Shiying Li ◽  
Robert D. Foreman ◽  
Jieyun Yin ◽  
Ning Dai ◽  
...  
Keyword(s):  
Spectral Analysis ◽  
Fecal Incontinence ◽  
Nerve Stimulation ◽  
Sacral Nerve Stimulation ◽  
Distal Colon ◽  
Colon Motility ◽  
Rectal Compliance ◽  
Sacral Nerve ◽  
Cholinergic Function ◽  
Colon Transit

Although sacral nerve stimulation (SNS) has been applied for treating constipation, its parameters were adopted from SNS for fecal incontinence, its effects are limited, and mechanisms are largely unknown. We investigated the effects and mechanism of SNS with appropriate parameters on constipation in rats treated with loperamide. First, using rectal compliance as an outcome measure, an experiment was performed to derive effective SNS parameters. Then, a 7-day SNS was performed in rats with constipation induced by loperamide. Autonomic functions were assessed by spectral analysis of heart rate variability (HRV) derived from an electrocardiogram. Serum levels of pancreatic polypeptide (PP), norepinephrine (NE), and acetylcholine (ACh) in colon were assessed. 1) Acute SNS at 5 Hz, 100 µs was found effective in enhancing rectal compliance and accelerating distal colon transit ( P < 0.05 vs. sham SNS). 2) The 7-day SNS normalized loperamide-induced constipation, assessed by the number, weight, and water content of fecal pellets, and accelerated the distal colon transit (29.4 ± 3.7 min with sham SNS vs. 16.4 ± 5.3 min with SNS but not gastric emptying or intestinal transit. 3) SNS significantly increased vagal activity ( P = 0.035) and decreased sympathetic activity ( P = 0.012), assessed by spectral analysis of HRV as well as by the serum PP. 4) SNS increased ACh in the colon tissue; atropine blocked the accelerative effect of SNS on distal colon transit. We concluded that SNS with appropriate parameters improves constipation induced by loperamide by accelerating distal colon motility, mediated via the autonomic-cholinergic function. NEW & NOTEWORTHY Although sacral nerve stimulation (SNS) has been applied for treating constipation, its parameters were adopted from SNS for fecal incontinence, effects are limited, and mechanisms are largely unknown. This paper shows that SNS with appropriate parameters improves constipation induced by loperamide by accelerating distal colon motility mediated via the autonomic-cholinergic function.

Six Years of Experience With Sacral Nerve Stimulation for Fecal Incontinence

2010 ◽  
Vol 53 (4) ◽  
pp. 414-421 ◽  
Author(s):  
Hanne B. Michelsen ◽  
Mark Thompson-Fawcett ◽  
Lilli Lundby ◽  
Klaus Krogh ◽  
Søren Laurberg ◽  
...  
Keyword(s):  
Fecal Incontinence ◽  
Nerve Stimulation ◽  
Sacral Nerve Stimulation ◽  
Years Of Experience ◽  
Sacral Nerve
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