title: Sacral anterior root stimulation improves bowel function in subjects with spinal cord injury.
abstract: METHODS
  Cross-sectional study.
  
  
  OBJECTIVE
  To evaluate the long-term effect of the sacral anterior root stimulator (SARS) on neurogenic bowel dysfunction in a large, well defined spinal cord injury (SCI) cohort.
  
  
  METHODS
  Department of Neuro-Urology, Bad Wildungen, Germany.
  
  
  METHODS
  Subjects undergone surgery at for SARS-SDAF (sacral deafferentation) between September 1986 and July 2011 (n=587) answered a questionnaire. In total, 277 SARS subjects were available for the baseline (recall) and follow-up comparison.
  
  
  RESULTS
  Median age was 49 years (range: 19-80), time from SCI to surgery was 10 years (range: 0-49) and from surgery to follow-up 13 (range: 1-25). Of the responders 73% used SARS for bowel emptying. On visual analog scale (VAS) ranging from 0-10 (best), satisfaction with SARS was 10. Baseline and follow-up comparison showed a decline in the median VAS score 0-10 (worst) for bowel symptoms from 6 (range: 4-8) to 4 (range: 2-6), P<0.0001; median neurogenic bowel dysfunction score from 17 (range: 11-2) to 11 (range: 9-15), P<0.0001; median St Marks score from 4 (range: 0-7) to 4 (range: 0-5), P=0.01; and median Cleveland constipation score from 7 (range: 6-10) to 6 (range: 4-8), P<0.0001. Use of suppositories, digital evacuation and mini enema and subjects totally dependent on assistance during defecation were significantly lower after SARS.
  
  
  CONCLUSIONS
  The SARS has the potential to be one of the few treatment methods targeting multiple organ dysfunctions following SCI.
authors.affiliation: 1] Pelvic Floor Unit, Department of Surgery P, Aarhus University Hospital, Aarhus, Denmark [2] Department of Neurosurgery, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: M M
authors.initials: MM
authors.lastname: Rasmussen
authors.affiliation: Department of Neuro-Urology, Werner-Wicker-Klinik, Bad Wildungen-Reinhardhausen, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Kutzenberger
authors.affiliation: Neurogastroenterology Unit, Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: K
authors.initials: K
authors.lastname: Krogh
authors.affiliation: Department of Neuro-Urology, Werner-Wicker-Klinik, Bad Wildungen-Reinhardhausen, Germany.
authors.forename: F
authors.initials: F
authors.lastname: Zepke
authors.affiliation: Department of Neurosurgery, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: C
authors.initials: C
authors.lastname: Bodin
authors.affiliation: Department of Neuro-Urology, Werner-Wicker-Klinik, Bad Wildungen-Reinhardhausen, Germany.
authors.forename: B
authors.initials: B
authors.lastname: Domurath
authors.affiliation: Pelvic Floor Unit, Department of Surgery P, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: P
authors.initials: P
authors.lastname: Christensen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003248:Constipation / Q000503:physiopathology / Q000628:therapy*; D003430:Cross-Sectional Studies; D004599:Electric Stimulation Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D055496:Neurogenic Bowel / Q000503:physiopathology / Q000628:therapy*; D012447:Sacrum; D013119:Spinal Cord Injuries / Q000503:physiopathology / Q000628:therapy*; D013126:Spinal Nerve Roots / Q000503:physiopathology / Q000601:surgery*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult