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Long term outcomes of sacral nerve stimulation for faecal incontinence

Introduction In patients with faecal incontinence (FI) who fail to benefit from medical or behavioural treatments sacral nerve stimulation (SNS) is now considered a first-line procedure.1 While the efficacy of treatment appears to be sustained in the short and medium term,2 the long-term results of therapy are relatively unknown. We present the 10 year follow-up results of SNS for faecal incontinence performed at a single centre. We present the 10 year follow-up results of SNS for faecal incontinence performed at a single centre. Table 1 PWE-069 Variable Baseline Temporary testing phase 3 Month permanent Latest follow-up St Mark's Score (SD) 20 (3.8), NA 7 (3.4) 8 (3.7) Ability to defer defecation in minutes (SD) <1 (0.9) 11 (4.8) 12 (4.7) 9 (6) Incontinence episodes per 2 weeks (SD) 27 (32.4) 2 (2.4) 2 (4.8) 4 (12.2) Methods All patients who underwent SNS for faecal incontinence from 1996 to 2002 were followed prospectively. Data was collected prospectively using bowel habit diaries and St Mark's continence scores. Treatment success was defined as > 50% reduction in episodes of faecal incontinence with SNS when compared to baseline symptoms. Results Between January 1996 and December 2002, 25 patients (M:F 2:23) (mean age 51 years (10.2)) underwent temporary SNS. Twenty four (96%) patients had a greater than 50% improvement in their ability to defer defecation during the trial phase and were considered suitable for chronic stimulation. Over a median follow-up of 108 months (range 88–150 months) the efficacy of neurostimulation was maintained in 21 of the 24 patients implanted as reflected in the St Mark's scores, ability to defer defecation and incontinence episodes per 2 weeks. Two patients (8%) lost efficacy at 48 and 60 months post permanent implant due to unknown reasons and had the device removed. One patient died at 36 months post permanent implant due to an unrelated event. Seven patients required change of battery at a mean of 72 months (SD 3.4). There were no further complications. Conclusion SNS can produce a sustained improvement in symptoms for up to 10 years in majority of patients implanted. Some patients will experience deterioration in their symptoms over time, for reasons yet unknown.