title: Sacral nerve modulation for defaecation and micturition disorders in patients with spina bifida.
abstract: OBJECTIVE
  Sacral nerve modulation is a well accepted method for the treatment of defaecation disorders and voiding dysfunction. Results of sacral nerve modulation in patients with spinal cord lesions are not well assessed, but preliminary results look poor. Therefore, the purpose of this study was to assess the effectiveness of sacral nerve modulation for defaecation disorders and voiding dysfunction in patients with spina bifida.
  
  
  METHODS
  Consecutive patients with spina bifida suffering from a myelomeningocele and combined faecal and urinary functional disorders that were eligible for peripheral nerve evaluation (PNE) were studied. A permanent sacral nerve modulation implantation was performed after successful PNE.
  
  
  RESULTS
  Ten patients (four female) were included in this study with a median age of 26.4 (range 11.1-41.0) years. In two the PNE was not possible. The median faecal incontinence days (6.0 vs 3.5) and episodes (8.5 vs 3.5) per 21 days decreased significantly during the 3-week period of PNE (P = 0.033). Only 3/10 (30%) patients had a more than 50% improvement and proceeded to a permanent sacral nerve modulation implantation. In one patient it was not possible to perform the permanent implant.
  
  
  CONCLUSIONS
  Preliminary results of sacral nerve modulation in a subgroup of spina bifida patients with combined faecal and urinary functional disorders look promising, but long-term results in larger patient groups need to be studied.
authors.affiliation: Department of Colorectal Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands.
authors.forename: S M P
authors.initials: SM
authors.lastname: Lansen-Koch
authors.forename: B
authors.initials: B
authors.lastname: Govaert
authors.forename: D
authors.initials: D
authors.lastname: Oerlemans
authors.forename: J
authors.initials: J
authors.lastname: Melenhorst
authors.forename: H
authors.initials: H
authors.lastname: Vles
authors.forename: E
authors.initials: E
authors.lastname: Cornips
authors.forename: E H J
authors.initials: EH
authors.lastname: Weil
authors.forename: E
authors.initials: E
authors.lastname: van Heurn
authors.forename: C G M I
authors.initials: CG
authors.lastname: Baeten
authors.forename: W G
authors.initials: WG
authors.lastname: van Gemert
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D003248:Constipation / Q000209:etiology / Q000628:therapy*; D004599:Electric Stimulation Therapy; D005242:Fecal Incontinence / Q000209:etiology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008591:Meningomyelocele / Q000150:complications; D012447:Sacrum / Q000294:innervation; D016135:Spinal Dysraphism / Q000150:complications*; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000209:etiology / Q000628:therapy*; D016055:Urinary Retention / Q000209:etiology / Q000628:therapy*; D055815:Young Adult