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CC BY-NC-ND 4.0 · Journal of Coloproctology 2023; 43(02): 104-109
DOI: 10.1055/s-0043-1769923
Original Article

Functional Outcomes and Satisfaction Rates of Sacral Nerve Stimulation in the Treatment of One and Multiples Pelvic Floor Dysfunctions

Sthela M. Murad-Regadas 
1   Department of Surgery, School of Medicine of the Federal University of Ceará, Fortaleza, CE, Brazil
,
Erico de Carvalho Holanda
2   Department of Surgery, School of Medicine of the UNICHRISTUS, Fortaleza, CE, Brazil
,
Carolina M. Regadas
2   Department of Surgery, School of Medicine of the UNICHRISTUS, Fortaleza, CE, Brazil
,
Amanda Souza Moreira
2   Department of Surgery, School of Medicine of the UNICHRISTUS, Fortaleza, CE, Brazil
,
Larissa M. Camara Fernandes
2   Department of Surgery, School of Medicine of the UNICHRISTUS, Fortaleza, CE, Brazil
,
Erica Uchoa Holanda
2   Department of Surgery, School of Medicine of the UNICHRISTUS, Fortaleza, CE, Brazil
,
Marina Murad Regadas
3   Department of Surgery, School of Medicine of the UNIFOR, Fortaleza, CE, Brazil
,
Emanuella C. Murad da Cruz
2   Department of Surgery, School of Medicine of the UNICHRISTUS, Fortaleza, CE, Brazil
› Author Affiliations Funding/Support None.
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Abstract

Objective Few studies have addressed the use of sacral nerve stimulation (SNS) in the treatment of patients with multiple pelvic floor dysfunctions (PFD). So, we evaluated the functional outcomes and level of satisfaction with SNS in selected patients with one or multiples PFD.

Methods A prospective database was used to collect information on eligible patients treated for PFD with SNS, and severity of symptoms was assessed with scores and satisfaction rates by visual analogue scale (VAS) at baseline and by the end of follow-up.

Results We recruited 70 patients, 98.6% of whom responded positively during the evaluation period (Global Response Assessment ≥ 50% for at least one type of PFD), resulting in the implantation of a permanent SNS device. Additionally, 49 of the patients (71%) had a single PFD (fecal incontinence [FI] = 38; constipation/obstructed defecation syndrome [C/ODS] = 11), while 20 (29%) had more than one PFD (double incontinence/n = 12; double incontinence + C/ODS/n = 8). All scores improved significantly between baseline (pre-SNS) and the end of follow-up (post-SNS), as did VAS in all groups (single and multiple PFD). The pre-SNS scores were higher in patients with a single PFD, including FI (Cleveland clinic Florida incontinence score [CCF-FI]) and C/ODS (Cleveland clinic constipation score [C-CCF] and the Renzi ODS score). The pre-SNS impact of VAS scores was similar in all groups (single and multiple PFD), but the VAS (post-SNS) was significantly lower (better response) for FI alone compared with multiple PFD.

Conclusion The SNS technique is an effective and safe option for patients with one or more PFD refractory to conservative measures. Response was positive for at least two PFD, based on reduced correspondent scores and satisfaction rate.

Keywords

neuromodulation - sacral nerve stimulation - fecal pelvic floor disorders - fecal incontinence

Source(s) of Support

None reported.


Financial Disclosure

None




Publication History

Received: 18 March 2023

Accepted: 19 April 2023

Article published online:
23 June 2023

© 2023. Sociedade Brasileira de Coloproctologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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