Treatment of slow-transit constipation with sacral nerve modulation.
OBJECTIVE
Constipation is common and a selection of the best treatment is difficult, especially for slow-transit constipation (STC). The aim of the study was to assess the effect of sacral nerve modulation (SNM) on STC.


METHODS
A retrospective analysis of patients with STC, treated with SNM was undertaken. All were evaluated by cinedefecography, colon transit-time, Cleveland Clinic Constipation Score (CCS), SF-36 Quality of Life (QoL) and a bowel diary. Initially, all patients underwent a temporary implant for 4 weeks. The criteria of success were disappearance of necessity for laxatives or enema requirement, and improvement in QoL.


RESULTS
Fifteen patients with STC were treated from March 2003 to May 2006. Nine (60%) underwent permanent implantation. After SNM, the mean improvement of Wexner Constipation Score (CCS) and QoL was 10 and 6.2 respectively. There were no complications. The mean follow-up period was 42 months.


CONCLUSIONS
Sacral nerve modulation seems to be a useful option for STC.
General Surgery IV, Hospital of Pisa, Pisa, Italy.
G
G
Naldini
J
J
Martellucci
L
L
Moraldi
R
R
Balestri
M
M
Rossi
D000328:Adult; D002908:Chronic Disease; D003248:Constipation / Q000503:physiopathology / Q000628:therapy*; D003672:Defecation / Q000502:physiology*; D004599:Electric Stimulation Therapy; D004567:Electrodes, Implanted; D005260:Female; D005772:Gastrointestinal Transit / Q000502:physiology*; D006801:Humans; D007420:Intestine, Large / Q000294:innervation*; D008160:Lumbosacral Plexus; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome