Sacral nerve stimulation for faecal incontinence: suboptimal therapeutic responses, adverse events, and their influence on treatment outcome: F11


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Abstract

Aim:There is little information on possible adverse events relating to sacral nerve stimulation (SNS) for faecal incontinence. This study aimed to identify the incidence of suboptimal therapeutic responses and adverse events and to determine their influence on the treatment outcome.Method:Prospectively collected data from 176 patients who underwent SNS were reviewed retrospectively. Patients' variables and reportable events were analysed by binary regression.Results:Overall, 592 reportable events (RE) were recorded from 150 patients (85.2%) at a median of 11 months (interquartile range (IQR): 4-26 months). Loss of efficacy (212 events, 87 patients), lack of efficacy (186 events, 68 patients) and pain/discomfort (126 events, 67 patients) accounted for more than 90% of RE. Loss of efficacy (Odds ratio (OR) 2.52, 95% confidence interval (CI): 1.327-4.789, P = 0.007), lack of efficacy (OR 2.80, CI: 1.462-5.357, P = 0.002) and pain in leg (OR 4.068, CI: 1.342-12.33, P = 0.013) werepredictors of unfavourable outcome in the medium-to long-term. At a median follow-up of 33 (IQR 20-52) months, 31 (17.6%) patients had had removal of the device or discontinued treatment.Conclusion:Suboptimal therapeutic responses and adverse events are not uncommon in SNS for faecal incontinence. They have a negative impact on treatment outcome.

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