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Sacral nerve modulation for defaecation and micturition disorders in patients with spina bifida
Author(s) -
LansenKoch S. M. P.,
Govaert B.,
Oerlemans D.,
Melenhorst J.,
Vles H.,
Cornips E.,
Weil E. H. J.,
van Heurn E.,
Baeten C. G. M. I.,
van Gemert W. G.
Publication year - 2012
Publication title -
colorectal disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.029
H-Index - 89
eISSN - 1463-1318
pISSN - 1462-8910
DOI - 10.1111/j.1463-1318.2011.02678.x
Subject(s) - medicine , spina bifida , fecal incontinence , urinary incontinence , implant , surgery , urination , urinary system , lumbosacral plexus , nerve root
Aim Sacral nerve modulation is a well accepted method for the treatment of defaecation disorders and voiding dysfunction. Results of sacral nerve modulation in patients with spinal cord lesions are not well assessed, but preliminary results look poor. Therefore, the purpose of this study was to assess the effectiveness of sacral nerve modulation for defaecation disorders and voiding dysfunction in patients with spina bifida. Method Consecutive patients with spina bifida suffering from a myelomeningocele and combined faecal and urinary functional disorders that were eligible for peripheral nerve evaluation (PNE) were studied. A permanent sacral nerve modulation implantation was performed after successful PNE. Results Ten patients (four female) were included in this study with a median age of 26.4 (range 11.1–41.0) years. In two the PNE was not possible. The median faecal incontinence days (6.0 vs 3.5) and episodes (8.5 vs 3.5) per 21 days decreased significantly during the 3‐week period of PNE ( P = 0.033). Only 3/10 (30%) patients had a more than 50% improvement and proceeded to a permanent sacral nerve modulation implantation. In one patient it was not possible to perform the permanent implant. Conclusion Preliminary results of sacral nerve modulation in a subgroup of spina bifida patients with combined faecal and urinary functional disorders look promising, but long‐term results in larger patient groups need to be studied.