AIM: Sacral nerve stimulation (SNS) is an effective treatment for urinary and faecal incontinence despite its mechanism of action being uncertain. Central nervous system involvement by "setting-up" neurological mechanisms appointed to control pelvic function have been hypothesized. The study aimed to evaluate whether the effects of long-term sacral nerve stimulation are memorized and therefore maintained after switching off the stimulator.
METHOD: Patients having sacral nerve stimulation for faecal and/or urinary incontinence for at least 1 year, had the stimulator turned off and the results monitored. Data recorded with the stimulator off were compared with post-implant data. If symptoms recurred the stimulator was switched back on.
PATIENTS: 19 patients entered the study. Fourteen had faecal and/or urinary incontinence and five had faecal incontinence alone. The symptoms were assessed by means of a bowel function diary and dedicated questionnaire .
RESULTS: In 10 patients symptoms recurred after a median off period of 3.4 months at different intervals with a probability of symptom relapse of 55%. The FIQL score did not show any significant difference in nine patients with the stimulator off for at least 1 year. No factors predictive of symptom recurrence were identified although an idiopathic aetiology, severity of disease and urinary incontinence had higher hazard ratios. During the off period, none of the scores and episodes of incontinence showed significant changes compared with the on period.
CONCLUSION: Rge effects of SNS on faecal and urinary incontinence were maintained in about half of patients after switching the stimulator off, but in some symptoms returned after different period of time. The data shed new light of possible effects of SNS on brain neuroplasticity in the control of continence.
Written by:
Altomare DF, Giannini I, Giuratrabocchetta S, Digennaro R. Are you the author?
Dept. of Emergency and Organ Transplantation, University Aldo Moro of Bari, Bari, Italy.
Reference: Colorectal Dis. 2013 Sep 14. Epub ahead of print.
doi: 10.1111/codi.12418
PubMed Abstract
PMID: 24102954
Go "Beyond the Abstract" - Read an article written by the authors for UroToday.com
UroToday.com Urinary Incontinence Section
