title: Is sacral neuromodulation here to stay? Clinical outcomes of a new treatment for fecal incontinence.
abstract: BACKGROUND
  Sacral neuromodulation (SNM) was approved by the FDA for the treatment of fecal incontinence (FI) in 2011, and previous industry-sponsored trials have shown excellent clinical outcomes. The purpose of this study is to examine clinical outcomes of patients treated during our initial experience with SNM.
  
  
  METHODS
  A prospective database of patients treated with SNM for FI by one of three colorectal surgeons at two separate institutions was maintained starting in 2011. Patients showing ≥50% improvement of weekly incontinent episodes during test stimulation were offered permanent implantation of the SNM device. Disease severity was tracked using the Wexner score.
  
  
  RESULTS
  A total of 145 patients received a full system implantation (of 152 who received test stimulation). The median preoperative Wexner score of 14 decreased to 3, 3 months after implantation and persisted to 12 months. At 12 months, 95.2% of patients achieved >50% improvement in Wexner Score and 67.6% achieved >75% improvement. The most common adverse event was infection (3.4%). Three patients (2.1%) required lead revision.
  
  
  CONCLUSIONS
  SNM is a safe and effective therapy for the treatment of FI. Postoperative patient surveillance is important, as many patients require programming changes, and some will require a lead revision over time.
authors.affiliation: Department of Surgery, Division of Colorectal Surgery, College of Medicine, University of Cincinnati, Cincinnati, OH, USA.
authors.forename: Bobby L
authors.initials: BL
authors.lastname: Johnson
authors.forename: Adam
authors.initials: A
authors.lastname: Abodeely
authors.forename: Martha A
authors.initials: MA
authors.lastname: Ferguson
authors.forename: Bradley R
authors.initials: BR
authors.lastname: Davis
authors.forename: Janice F
authors.initials: JF
authors.lastname: Rafferty
authors.forename: Ian M
authors.initials: IM
authors.lastname: Paquette
mesh_terms: D000368:Aged; D003672:Defecation / Q000502:physiology*; D004599:Electric Stimulation Therapy / Q000379:methods*; D005242:Fecal Incontinence / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008160:Lumbosacral Plexus; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome