Sacral nerve stimulation for fecal incontinence: causes of surgical revision, from a series of 123 patients operated on in a single institution: OP16

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Aim:Sacral nerve stimulation is offered to patientspresenting with fecal incontinence of neurological etiology. One of the causes of failure ofthisprocedure is stimulator dysfunction. We report our experience on that particular topic.Method:From September 2001 to August 2009, 123 patients (105 women) of mean age 56 years were operated on for neurological (n = 104) or idiopathic (n = 19) faecal incontinence. The meanpreoperative Cleveland Clinic score was 13/20 (range 6/20-19/20). Eighty seven patients out of 123 had a positive test and underwent stimulator implantation. Any stimulator dysfunction wasprospectively studied.Results:Among the 87 patients, 21 had removal of the stimulatorfor the following reasons: total or partial inefficacy in 9, suppuration in 4, stimulator dysfunction following high power Magnetic Resonance Imaging in 2, battery end oflife in 6. Four other patients had stimulator repositioning because of pain in 2 and a too superficial situation in 2. Lastly, 11 further patients had to be re-operated on for re-implantation of electrode for displacement (n = 2), broken electrode (n = 2), pain (n = 3), and dysfunction (n = 4).Conclusion:Sacral nerve stimulation is a recognized treatment for faecal incontinence that comprises around 40% of re-operation for stimulator dysfunction.

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