title: Can sacral neuromodulation improve minor incontinence symptoms in doubly incontinent patients successfully treated for major incontinence symptoms?
abstract: OBJECTIVE
  To describe the effect of sacral nerve modulation (SNM) on less severe types of incontinence in patients who were successfully implanted for either urinary or fecal incontinence, and who presented with double incontinence. When conservative treatments fail, SNM is a first-line treatment for patients with urge urinary or fecal incontinence.
  
  
  METHODS
  All patients who received SNM between 2005 and 2010 at 5 hospitals and who still had the implant were included in our survey. All received a urinary and fecal change and quality of life questionnaire by mail to complete.
  
  
  RESULTS
  Of the 51 questionnaires sent out, 37 were returned, for a 72.5% response rate. The population was composed of 97.3% women, with a mean age of 56.8 years (SD 14). The main indication for SNM was urge urinary incontinence in 15 patients (40.5%) and fecal incontinence in 22 patients (59.5%). Eighteen patients (48.7%) had improvements in both urinary and fecal incontinence symptoms. The percentage increased to 53.3% (16/30) in the group of patients with urge urinary incontinence associated with fecal incontinence. Patients who reported an improvement in double incontinence symptoms complained more often of urge urinary incontinence than other patients (P=.04).
  
  
  CONCLUSIONS
  Of the doubly incontinent patients who were successfully implanted for a predominant type of incontinence (ie, urinary or fecal incontinence), 48.7% had an improvement in the other type of incontinence. Patients with urge urinary incontinence associated with fecal incontinence were more likely to report an improvement in double incontinence than the other patients.
authors.affiliation: Urology Department, Rouen University Hospital, Rouen, France.
authors.forename: Romain
authors.initials: R
authors.lastname: Caremel
authors.forename: Henri
authors.initials: H
authors.lastname: Damon
authors.forename: Alain
authors.initials: A
authors.lastname: Ruffion
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Chartier-Kastler
authors.forename: Guillaume
authors.initials: G
authors.lastname: Gourcerol
authors.forename: Francis
authors.initials: F
authors.lastname: Michot
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Menard
authors.forename: Philippe
authors.initials: P
authors.lastname: Grise
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Leroi
mesh_terms: D000367:Age Factors; D000368:Aged; D015331:Cohort Studies; D004599:Electric Stimulation Therapy / Q000379:methods*; D004567:Electrodes, Implanted; D005242:Fecal Incontinence / Q000175:diagnosis / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008160:Lumbosacral Plexus; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D011788:Quality of Life; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D012737:Sex Factors; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000175:diagnosis / Q000628:therapy*