[Sacral neuromodulation in fecal incontinence. A pilot prospective experience in Argentina].
BACKGROUND
Anal incontinence is a severe physical and emotional condition that affects quality of life. Its treatment with neuromodulation, that consists in sacral roots electrical stimulation, has became a therapeutic option.


OBJECTIVE
This study was designed to present the surgical technique and the first prospective experience in neuromodulation for fecal incontinence in Argentina.


METHODS
Four females with severe fecal incontinence (mean score 17/20) were included. Anorectal physiology testing and anal ultrasound were performed before surgery. Due to failed medical treatment and the presence of an intact anal sphincter, sacral neuromodulation was indicated. After temporary sacral nerve evaluation, definitive neuromodulator was implanted.


RESULTS
After 13 months the incontinence score and the number of weekly escapes decrese from 17/20 to 1.7/20 (p = 0.059) and from 62 to 0.2 (p = 0.059). Quality of life scores also improves but not statiscally significative.


CONCLUSIONS
Sacral neuromodulation in fecal incontinence is useful. It is effective in patients who had failed maximum conservative therapies with the advantage of testing before definitive.
Lumi
Carlos M
CM
Unidad de Coloproctología, Departamento de Cirugía, Hospital de Gastroenterología Dr Carlos Bonorino Udaondo, Av. Caseros 2061 (1264) Ciudad Autónoma de Buenos Aires, Argentina. miguelumi@hotmail.com
Muñoz
Juan P
JP
La Rosa
Luciana
L
D000368:Aged; D004599:Electric Stimulation Therapy / Q000379:methods*; D005242:Fecal Incontinence / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008160:Lumbosacral Plexus; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome