title: Long-term outcome of sacral nerve stimulation for fecal incontinence.
abstract: OBJECTIVE
  Sacral nerve stimulation is a safe and effective procedure for fecal incontinence. We investigated whether its efficacy is maintained long term.
  
  
  METHODS
  Sixty patients with fecal incontinence underwent permanent sacral nerve stimulation. Patients' data were prospectively recorded in the national registry of the Italian Group of sacral nerve stimulation. The severity of fecal incontinence was evaluated by the Wexner score, and data were collected in a bowel function diary. Quality of life was evaluated by the Italian version of the Medical Outcomes Survey Short Form (SF-36) questionnaire.
  
  
  RESULTS
  Fifty-two patients were available for long-term follow-up lasting at least 5 years. Compared with baseline, the Wexner score decreased significantly after definitive implantation (from 15 +/- 4 to 5 +/- 5, P < 0.001). At least 50 percent improvement in continence was achieved in 74 percent of the patients, and at least 70 percent improvement (median value) was achieved in 50 percent. The mean number of solid/liquid incontinence episodes decreased significantly from 0.5 (+/-0.5) to 0.1 (+/-0.3) per day (P = 0.004). Quality of life improved in all domains. The overall mean improvement in SF-36 scores was 39.8 percent. Both mean resting and squeeze anal pressures increased significantly, and maximum volume tolerated decreased significantly.
  
  
  CONCLUSIONS
  Sacral nerve stimulation maintains its efficacy long term, not only in regard to control of symptoms but also regarding quality of life.
authors.affiliation: Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy. altomare@clichiru.uniba.it
authors.forename: Donato F
authors.initials: DF
authors.lastname: Altomare
authors.forename: Carlo
authors.initials: C
authors.lastname: Ratto
authors.forename: Ezio
authors.initials: E
authors.lastname: Ganio
authors.forename: Paola
authors.initials: P
authors.lastname: Lolli
authors.forename: Alessandra
authors.initials: A
authors.lastname: Masin
authors.forename: Roberto D
authors.initials: RD
authors.lastname: Villani
mesh_terms: D004599:Electric Stimulation Therapy / Q000009:adverse effects; D004567:Electrodes, Implanted / Q000009:adverse effects; D005242:Fecal Incontinence / Q000209:etiology / Q000628:therapy*; D005260:Female; D006801:Humans; D008160:Lumbosacral Plexus; D008297:Male; D008875:Middle Aged; D011788:Quality of Life