Can cerebral sensory evoked potentials (SEP)predict outcome of sacral nerve modulation (SNM) for functional bowel disorders?: OP17


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Abstract

Aim:To determine the influence of SNM on SEP in patients with incontinence (I) and constipation (C).Method:The threshold (mV) and latency (msec) of pudendal nerve stimulation before (T0) and 1 month after (T1-21Hz, T2-40Hz) SNM to induce a cerebral SEP were measured in 23 incontinent and 23 constipated patients. The results were correlated with clinical outcome at 6 months.Results:In 16 incontinent patients with successful outcome (Wexner ≤ 7) there was a significant fall after SNM in pudendal SEP threshold (4.02 mV-T0; 2.59 mV-T1, P < 0.011; 2.99 mV 40Hz-T2, P < 0.033). There was also a significant reduction in P40 latency (38.81 ms-T0, 37.49 ms-T2, P < 0.049) and N50 latency (46.97 msec-T0, 45.23 msec-T2, P < 0.045). In the seven with unsuccessful outcome, there was no change on pudendal stimulation. In 16 constipated patients with successful outcome (Wexner ≤ 15) there was a significant reduction in P40 latency (39.86 ms-T0, 38.23 ms-T2, P < 0.062) and N50 latency (46.93 msec-T0, 46.13 msec-T2, P < 0.565). In the seven constipated patients with unsuccessful outcome there was a fall in P40 latency (41.09 msec-T0, 38.81 msec-T2, P < 0.031).Conclusion:In incontinent and constipated patients having a successful outcome, SNM reduced threshold and latency of SEP after left-sided pudendal nerve stimulation. This may be of value in selecting patients for SNM.

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