title: Does sacral nerve stimulation improve global pelvic function in women?
abstract: OBJECTIVE
  Many women undergoing sacral neuromodulation for faecal incontinence have coexisting pelvic floor dysfunction. We used a global pelvic-floor assessment questionnaire to evaluate the effect of sacral neuromodulation on non-bowel related symptomatology.
  
  
  METHODS
  The electronic Personnel Assessment Questionnaire - Pelvic Floor (ePAQ-PF) is a validated Web-based electronic pelvic floor questionnaire. Women with faecal incontinence underwent assessment using the ePAQ. Pre- and poststimulator data were analysed over a 4.5-year period.
  
  
  RESULTS
  Forty-three women (mean age 56.5 years; median follow up 6.8 months) were included. All (100%) had urinary symptoms, 81.4% had vaginal symptoms and 85.7% described some sexual dysfunction. There was a significant improvement in faecal incontinence and in bowel-related quality of life (P < 0.005) as well as in irritable bowel syndrome (IBS)-related symptoms (P < 0.01) and in bowel-related sexual heath (P < 0.01). Symptoms of vaginal prolapse significantly improved (P = 0.05). There was also improvement in symptoms of overactive bladder (P = 0.005) and in urinary-related quality of life (P < 0.05). A global health improvement was reported in 58.1%, mainly in bowel evacuation (P < 0.01) and in vaginal pain and sensation (P < 0.05). In sexually active female patients, significant improvements in vaginal and bowel-related sexual health were seen (P < 0.005). Improvement in general sex life following stimulation was reported in 53.3%.
  
  
  CONCLUSIONS
  A Web-based electronic pelvic-floor assessment questionnaire has demonstrated global improvement in pelvic floor function in bowel, urinary, vaginal and sexual dimensions in women following sacral neuromodulation for faecal incontinence.
authors: Northern General Hospital, Sheffield, UK.
authors: A M
authors: AM
authors: Jadav
authors: H
authors: H
authors: Wadhawan
authors: G L
authors: GL
authors: Jones
authors: L W
authors: LW
authors: Wheldon
authors: S C
authors: SC
authors: Radley
authors: S R
authors: SR
authors: Brown
mesh_terms: D004599:Electric Stimulation Therapy / Q000379:methods*; D005242:Fecal Incontinence / Q000150:complications / Q000628:therapy*; D005260:Female; D006801:Humans; D058542:Implantable Neurostimulators; D008875:Middle Aged; D059952:Pelvic Floor Disorders / Q000150:complications / Q000628:therapy*; D056887:Pelvic Organ Prolapse / Q000150:complications / Q000628:therapy*; D011788:Quality of Life; D012445:Sacrococcygeal Region; D012735:Sexual Dysfunction, Physiological / Q000209:etiology / Q000628:therapy; D013127:Spinal Nerves; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000150:complications / Q000628:therapy*
keywords: Faecal incontinence; pelvic floor; questionnaire; sacral nerve stimulation