title: Sacral nerve stimulation for fecal incontinence: long-term outcomes.
abstract: BACKGROUND
  Numerous studies advocate the short-term benefits of sacral nerve stimulation for fecal incontinence, but there has been a paucity of studies on longer-term outcomes.
  
  
  OBJECTIVE
  The objective of this study was to report the long-term outcome of sacral nerve stimulation performed for fecal incontinence at a single institution.
  
  
  METHODS
  Between January 2004 and May 2007, 53 patients underwent definitive sacral nerve stimulation for fecal incontinence at our institution. Prospectively recorded baseline information, including Wexner incontinence scores and standard short-form (SF-12) health survey scores, were compared with scores at follow-up.
  
  
  RESULTS
  Forty-one patients were available for long-term follow-up with a mean duration of 51 months. The median Wexner score decreased from a baseline of 11.5 (range, 3.0-18.0) to 8.0 (range, 0.0-18.0) at follow-up. The mean difference in Wexner score was 2.7 (P < .001). There was no statistically significant change in SF-12 physical scores, but a small but highly significant change occurred in SF-12 mental scores. The median SF-12 mental domain score was 49.5 (range, 15.0-62.1) at baseline, and 57.0 (range, 20.0-64.0) at follow-up, with a mean difference of 4.5 (P = .006). Subgroup analysis performed comparing patients with or without prior intersphincteric silicon biomaterial implants demonstrated a mean difference in Wexner score of -3.5 (no implant) vs 0.0 (previous implant), with P < .09 (not statistically significant).
  
  
  CONCLUSIONS
  Sacral nerve stimulation results in a statistically significant improvement in fecal incontinence scores in the long term.
authors: Colorectal Surgery Unit, Royal Melbourne Hospital, Melbourne, Australia. drjamestlim@gmail.com
authors: James T
authors: JT
authors: Lim
authors: Ian A G
authors: IA
authors: Hastie
authors: Richard J
authors: RJ
authors: Hiscock
authors: Susan M
authors: SM
authors: Shedda
mesh_terms: D001003:Anal Canal / Q000294:innervation / Q000503:physiopathology; D004599:Electric Stimulation Therapy / Q000009:adverse effects / Q000379:methods*; D004567:Electrodes, Implanted; D004868:Equipment Failure; D005242:Fecal Incontinence / Q000628:therapy*; D005260:Female; D006801:Humans; D008160:Lumbosacral Plexus / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome