| Sacral nerve stimulation for faecal incontinence due to systemic sclerosis. | |
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MedLine Citation:
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PMID: 12427794 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Faecal incontinence occurs in over one third of patients with systemic sclerosis. The aetiology is multifactorial. Conventional treatment is often unsuccessful. Sacral nerve stimulation is a new effective treatment for resistant faecal incontinence. AIMS: To evaluate sacral nerve stimulation in patients with systemic sclerosis. PATIENTS: Five women, median age 61 years (30-71), with scleroderma associated faecal incontinence were evaluated. All had failed maximal conventional treatment. Median number of preoperative weekly episodes of incontinence was 15 (7-25), median duration of incontinence was five years (5-9), and scleroderma 13 years (4-29). METHODS: All patients were screened with temporary stimulation. Those who benefited underwent permanent implantation. At baseline and after stimulation a bowel diary, the SF-36 quality of life assessment, endoanal ultrasound, and anorectal physiology were performed. RESULTS: Four patients were continent at a median follow up of 24 months (6-60). One patient failed temporary stimulation and was not permanently implanted. The weekly episodes of incontinence decreased from 15, 11, 23, and 7 to 0. Urgency resolved (median time to defer <1 minute (0-1) v 12.5 minutes (5-15)). Quality of life, especially social function, improved. Endoanal ultrasound showed an atrophic internal anal sphincter (median width 1.0 mm (0-1.6)). Anorectal physiology showed an increase in median resting pressure (37 pre v 65 cm H(2)O post) and squeeze pressure (89 v 105 cm H(2)O). Stimulation produced enhanced rectal sensitivity to distension. There were no major complications. CONCLUSIONS: Sacral nerve stimulation is a safe and effective treatment for resistant faecal incontinence secondary to scleroderma. The benefit is maintained in the medium term. |
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Authors:
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N J Kenefick; C J Vaizey; R J Nicholls; R Cohen; M A Kamm |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Gut Volume: 51 ISSN: 0017-5749 ISO Abbreviation: Gut Publication Date: 2002 Dec |
Date Detail:
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Created Date: 2002-11-12 Completed Date: 2002-12-17 Revised Date: 2009-11-18 |
Medline Journal Info:
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Nlm Unique ID: 2985108R Medline TA: Gut Country: England |
Other Details:
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Languages: eng Pagination: 881-3 Citation Subset: AIM; IM |
Affiliation:
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St Mark's Hospital, London, UK. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Anal Canal / physiopathology Electric Stimulation Therapy / methods* Electrodes, Implanted Fecal Incontinence / etiology, physiopathology, therapy* Female Humans Lumbosacral Plexus* Middle Aged Rectum / physiopathology Scleroderma, Systemic / complications*, physiopathology |
| Comments/Corrections | |
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