Matzel K (2022)
Publication Type: Journal article, Review article
Publication year: 2022
Sacral neuromodulation (SNM) is an established surgical therapy for fecal incontinence (PI). The spectrum of indications has evolved over the last two decades. The role of SNM is the surgical treatment algorithm for FI is now central. Currently, the indications include a wide variety of pathophysiological and pathomorphological causes of FI, but also reach beyond FI to include complex conditions such as low anterior resection syndrome (LARS) and patients with concomitant evacuation disorders. The technique's minimal invasiveness, low risk and low comorbidity contributed to its success and increased acceptance, as did the option of a therapeutic test and a robust patient selection-patients are selected for chronic stimulation by a pragmatic approach, based on the clinical outcome of a highly predictive value of trial stimulation if positive-its sustained clinical efficacy, and reproducible outcomes. TO further improve the outcome of SNM, both for the test stimulation and the chronic stimulation, crucial elements of the therapy such as electrode placement, programming, and reprogramming have been revisited and standardized. This article addresses the scope of indications, highlights the reevaluation and standardization of the implant technique and updates on recent guidance for programming and troubleshooting. The standardization should lead to fewer side effects, more programming options, less battery consumption with increased battery longevity, and improved clinical outcome.
APA:
Matzel, K. (2022). Update on neuromodulation for fecal incontinence. Annals of Laparoscopic and Endoscopic Surgery. https://doi.org/10.21037/ales-2022-03
MLA:
Matzel, Klaus. "Update on neuromodulation for fecal incontinence." Annals of Laparoscopic and Endoscopic Surgery (2022).
BibTeX: Download