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Sacral Neuro-modulation for Treating Faecal Incontinence: Assessment of Symptom Improvement Using an Online Patient Assessment Questionnaire

Naveed Altaf, MRCS, Tim Maheswaran, Anil Reddy, FRCS, MD

JAMES COOK UNIVERSITY HOSPITAL

Introduction – Sacral nerve stimulation is now considered an effective treatment option for faecal incontinence in those patients who have had little success with conservative treatment. The efficacy of this treatment is assessed subjectively.

We aim to assess the effectiveness of this treatment by using an online patient satisfaction questionnaire (EPAQ).

Methods – A prospectively collected data on patients who had permanent sacral nerve implant for faecal incontinence was analysed. EPAQ, which is a validated online patient satisfaction tool, was used to assess the efficacy of treatment. Domains assessed included improvement in irritable bowel symptoms, constipation, evacuation, continence and quality of life. First phase of treatment involved insertion of a temporary electrode for 14 days and those patients with significant improvement in their symptoms were considered for a permanent implant.

Results – 22 female patients with mean age of 56 years (range: 37-77years), underwent SNS. 5(23%) had only faecal incontinence [Wexner score > 12] and 17 (77%) had predominantly overactive bladder symptoms along with some faecal incontinence [Wexner scores 7-12].19 (86%) patients completed the questionnaire following permanent insertion of the implant.Results are summerised in the table :

Domain Improvement in Symptoms No Improvement
n (%)
Worsening of symptoms
n (%)
n(%) Average Improvement
Irritable bowel 12 (63%) 42% 2 (11%)

5 (26%)

Irritable bowel evacuation 13 (81%) 63% 1 (6%) 2 (13%)
Incontinence 13 (81%) ) 53% 1 (6%) 2 (13%)
QoL 7 (41%) 47% 6 (35%) 4 (24%)

Conclusion – Even though a small cohort, our results have shown that SNS not only helps in decreasing the episodes of faecal incontinence but also improves quality of life.


Session: Poster Presentation

Program Number: P065

111

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