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Anales del Sistema Sanitario de Navarra
versión impresa ISSN 1137-6627
Resumen
MIGUEL VALENCIA, MJ de et al. Sacral nerve stimulation for the treatment of severe fecal incontinence: long-term quality of life and functional outcomes. Anales Sis San Navarra [online]. 2020, vol.43, n.3, pp.347-358. Epub 21-Jun-2021. ISSN 1137-6627. https://dx.doi.org/10.23938/assn.0922.
Background
The aim is to determine whether good functional and quality of life results of sacral nerve stimulation (SNS) in patients with severe fecal incontinence are maintained in the long-term.
Material and methods
Consecutive cohort of patients with severe fecal incontinence not responding to conservative (drugs and/or biofeedback) or surgical (sphincteroplasty) treatment, undergoing SNS between 2002 and 2013. Patients with a definitive implant were individually assessed in consultation throughout the follow-up, until January 2016. Defecatory function was assessed by Wexner score and stool diary, and perceived quality of life by FIQL and EQ-5D questionnaires.
Results
Acute percutaneous nerve evaluation (PNE) was performed on 93 patients; a temporary electrode was implanted in 91 (79.1% women, mean age 62.5 years), obtaining a good functional response in 64. A permanent implant was performed in 61 patients, with a mean follow-up of 78.1 months (SD: 35.4; range 1-161); at the end of the study 42 patients remained in follow-up. A significant decrease was observed in the number of days per week with an incontinent episode, from 4.98 (SD 2.1) to 1.25 (SD 1.7), and in Wexner score from 16.88 (SD 2.74) to 6.95 (SD 3.54). Specific FIQL and generic EQ-5D questionnaires showed a significant improvement in quality of life.
Conclusion
Long-term functional and quality of life outcomes of SNS for the treatment of severe faecal incontinence is maintained, with individual follow-ups that reach 10 years
Palabras clave : Fecal incontinence; Sacral nerve stimulation; Follow-up; Quality of life; Defecatory function.