| Sacral nerve stimulation for fecal incontinence: external anal sphincter defect vs. intact anal sphincter. | |
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MedLine Citation:
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PMID: 18484136 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: This prospective study was designed to assess the effectiveness of sacral nerve stimulation for fecal incontinence in patients with external anal sphincter defect and to evaluate its efficacy regarding presence and size of sphincter defect. METHODS: Fifty-three consecutive patients who underwent sacral nerve stimulation for fecal incontinence were divided into two groups: external anal sphincter defect group (n = 21) vs. intact sphincter group (n = 32). Follow-up was performed at 3, 6, and 12 months with anorectal physiology, Wexner's score, bowel diary, and quality of life questionnaires. RESULTS: The external anal sphincter defect group (defect <90 degrees:defect 90 degrees-120 degrees = 11:10) and intact sphincter group were comparable with regard to age (mean, 63 vs. 63.6) and sex. Incidence of internal anal sphincter defect and pudendal neuropathy was similar. All 53 patients benefited from sacral nerve stimulation. Weekly incontinent episodes decreased from 13.8 to 5 (P < 0.0001) for patients with external anal sphincter defects and from 6.7 to 2 (P = 0.001) for patients with intact sphincter at 12-month follow-up. Quality of life scores improved in both groups (P < 0.0125). There was no significant difference in improvement in functional outcomes after sacral nerve stimulation between patients with or without external anal sphincter defects. Clinical benefit of sacral nerve stimulation was similar among patients with external anal sphincter defects, irrespective of its size. Presence of pudendal neuropathy did not affect outcome of neurostimulation. CONCLUSIONS: Sacral nerve stimulation for fecal incontinence is as effective in patients with external anal sphincter defects as those with intact sphincter and the result is similar for defect size up to 120 degrees of circumference. |
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Authors:
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Miranda K Y Chan; Joe J Tjandra |
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Publication Detail:
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Type: Comparative Study; Journal Article Date: 2008-05-17 |
Journal Detail:
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Title: Diseases of the colon and rectum Volume: 51 ISSN: 1530-0358 ISO Abbreviation: Dis. Colon Rectum Publication Date: 2008 Jul |
Date Detail:
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Created Date: 2008-07-03 Completed Date: 2008-07-17 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0372764 Medline TA: Dis Colon Rectum Country: United States |
Other Details:
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Languages: eng Pagination: 1015-24; discussion 1024-5 Citation Subset: IM |
Affiliation:
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Department of Colorectal Surgery, Epworth Hospital, University of Melbourne, Melbourne, Australia. mirchan@hotmail.com |
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Anal Canal / injuries, physiopathology* Electric Stimulation Therapy / methods* Fecal Incontinence / etiology, physiopathology, therapy* Female Follow-Up Studies Humans Lumbosacral Plexus / physiopathology* Male Middle Aged Prospective Studies Quality of Life Questionnaires Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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