Long-term outcome of sacral neuromodulation for chronic refractory constipation

Maeda Y, Kamm MA, Vaizey CJ, Matzel K, Johansson C, Rosen H, Baeten CG, Laurberg S (2017)

Publication Type: Journal article

Publication year: 2017

Journal

Techniques in Coloproctology Springer Verlag (Germany)

Book Volume: 21

Pages Range: 277-286

Journal Issue: 4

DOI: 10.1007/s10151-017-1613-0

Abstract

Sacral neuromodulation has been reported as a treatment for severe idiopathic constipation. This study aimed to evaluate the long-term effects of sacral neuromodulation by following patients who participated in a prospective, open-label, multicentre study up to 5 years.Patients were followed up at 1, 3, 6, 12, 24, 36, 48 and 60 months. Symptoms and quality of life were assessed using bowel diary, the Cleveland Clinic constipation score and the Short Form-36 quality-of-life scale.Sixty-two patients (7 male, median age 40 years) underwent test stimulation, and 45 proceeded to permanent implantation. Twenty-seven patients exited the study (7 withdrawn consent, 7 loss of efficacy, 6 site-specific reasons, 4 withdrew other reasons, 2 lost to follow-up, 1 prior to follow-up). Eighteen patients (29%) attended 60-month follow-up. In 10 patients who submitted bowel diary, their improvement of symptoms was sustained: the number of defecations per week (4.1 ± 3.7 vs 8.1 ± 3.4, mean ± standard deviation, p < 0.001, baseline vs 60 months) and sensation of incomplete emptying (0.8 ± 0.3 vs 0.2 ± 0.1, p = 0.002). In 14 patients (23%) with Cleveland Clinic constipation score, improvement was sustained at 60 months [17.9 ± 4.4 (baseline) to 10.4 ± 4.1, p < 0.001]. Some 103 device-related adverse events were reported in 27 (61%).Benefit from sacral neuromodulation in the long-term was observed in a small minority of patients with intractable constipation. The results should be interpreted with caution given the high dropout and complication rate during the follow-up period.

Authors with CRIS profile

Klaus Matzel Lehrstuhl für Allgemein- und Viszeralchirurgie

Additional Organisation(s)

Department of Surgery

Involved external institutions

Aarhus University Hospital / Aarhus Universitetshospital DK Denmark (DK) Maastricht University NL Netherlands (NL) Danderyds sjukhus SE Sweden (SE) St. Mark's Hospital GB United Kingdom (GB) Imperial College London / The Imperial College of Science, Technology and Medicine GB United Kingdom (GB)

How to cite

APA:

Maeda, Y., Kamm, M.A., Vaizey, C.J., Matzel, K., Johansson, C., Rosen, H.,... Laurberg, S. (2017). Long-term outcome of sacral neuromodulation for chronic refractory constipation. Techniques in Coloproctology, 21(4), 277-286. https://doi.org/10.1007/s10151-017-1613-0

MLA:

Maeda, Yasuko, et al. "Long-term outcome of sacral neuromodulation for chronic refractory constipation." Techniques in Coloproctology 21.4 (2017): 277-286.

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