title: Sacral Nerve Stimulation Fails to Offer Long-term Benefit in Patients With Slow-Transit Constipation.
abstract: BACKGROUND
  Sacral nerve stimulation is proposed as a treatment for slow-transit constipation. However, in our randomized controlled trial we found no therapeutic benefit over sham stimulation. These patients have now been followed-up over a long-term period.
  
  
  OBJECTIVE
  The purpose of this study was to assess the long-term efficacy of sacral nerve stimulation in patients with scintigraphically confirmed slow-transit constipation.
  
  
  METHODS
  This study was designed for long-term follow-up of patients after completion of a randomized controlled trial.
  
  
  METHODS
  It was conducted at an academic tertiary public hospital in Sydney.
  
  
  METHODS
  Adults with slow-transit constipation were included.
  
  
  METHODS
  At the 1- and 2-year postrandomized controlled trial, the primary treatment outcome measure was the proportion of patients who reported a feeling of complete evacuation on >2 days per week for ≥2 of 3 weeks during stool diary assessment. Secondary outcome was demonstration of improved colonic transit at 1 year.
  
  
  RESULTS
  Fifty-three patients entered long-term follow-up, and 1 patient died. Patient dissatisfaction or serious adverse events resulted in 44 patients withdrawing from the study because of treatment failure by the end of the second year. At 1 and 2 years, 10 (OR = 18.8% (95% CI, 8.3% to 29.3%)) and 3 patients (OR = 5.7% (95% CI, -0.5% to 11.9%)) met the primary outcome measure. Colonic isotope retention at 72 hours did not differ between baseline (OR = 75.6% (95% CI, 65.7%-85.6%)) and 1-year follow-up (OR = 61.7% (95% CI, 47.8%-75.6%)).
  
  
  CONCLUSIONS
  This study only assessed patients with slow-transit constipation.
  
  
  CONCLUSIONS
  In these patients with slow-transit constipation, sacral nerve stimulation was not an effective treatment.
authors: 1 St. George Hospital Clinical School, University of New South Wales, Sydney, New South Wales, Australia 2 Department of Colorectal Surgery, St. George Hospital, Sydney, New South Wales, Australia 3 Department of Surgery, Concord Repatriate Hospital, Sydney, New South Wales, Australia 4 Department of Gastroenterology, St. George Hospital, Sydney, New South Wales, Australia 5 Department of Gastroenterology and Surgery, Flinders Medical Centre, Flinders University, Adelaide, South Australia, Australia.
authors: Vicki
authors: V
authors: Patton
authors: Peter
authors: P
authors: Stewart
authors: David Z
authors: DZ
authors: Lubowski
authors: Ian J
authors: IJ
authors: Cook
authors: Phil G
authors: PG
authors: Dinning
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003248:Constipation / Q000503:physiopathology / Q000628:therapy*; D018592:Cross-Over Studies; D004311:Double-Blind Method; D004599:Electric Stimulation Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D005772:Gastrointestinal Transit; D006801:Humans; D008160:Lumbosacral Plexus; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D055815:Young Adult