Colorectal Dis. 2020 Sep 20. doi: 10.1111/codi.15369. Online ahead of print.

Cosimo Alex Leo ^1 2, Gregory P Thomas ¹, Elissa Bradshaw ¹, Smriti Karki ³, Jonathan D Hodkinson ^1 2, Jamie Murphy ², Carolynne J Vaizey ^1 2

Author information

• ¹Sir Alan Parks Physiology Unit, St Mark's Hospital, Northwest London University NHS Trust, Harrow, UK.
• ²Imperial College London, UK.
• ³Northwick Park Hospital, London North West NHS Trust, UK.

Abstract

Aim: Sacral Nerve Stimulation (SNS) is a minimally invasive treatment for faecal incontinence (FI). We report our experience of patients who have undergone SNS for FI with a minimum of five years follow-up. This is a single centre prospective observational study with the aim to assess the long-term function of SNS.

Method: All patients implanted with SNS were identified from our prospective database. Date of implantation, first and last clinic follow-up, surgical complications and St Mark's incontinence scores were abstracted and analysed.

Results: From 1996 to 2014, 381 patients were considered for SNS. Of these, 256 patients met the study inclusion criteria. Median age at implantation was 52 years (Range 18 - 81). The ratio female : male was 205 : 51. Indications were urge FI (25%), passive FI (17.9%) and mixed FI (57%). The median of incontinence score at baseline was 19/24 and this improved to 7/24 at 6 months follow up. Of the total cohort, 235 patients received a medium term follow up (median 110 months (Range 12 - 270) with a median continence score of 10/24 which was also confirmed at the telephone long term follow up on 185 patients[132 months (60 - 276) ].a

Conclusion: This study demonstrates that SNS is an effective treatment in the long term. SNS results in an improvement of validated scores for approximately 60% of patients; however, there is a significant reduction of efficacy over time due to underlying causes.