Short-term effectiveness and safety of sacral nerve modulation in the treatment of bladder-and-bowel dysfunction: a preliminary exploration of 16 cases
[Objectives] To explore the short-term effectiveness and safety of sacral nerve modulation (SNM) in the treatment of bladder-and-bowel dysfunction (BBD). [Methods] A retrospective analysis was conducted on the clinical data of 16 patients with BBD who underwent SNM between April 2021 and August 2023...
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| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | zho |
| Published: |
Editorial Office of Journal of Colorectal & Anal Surgery
2023-12-01
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| Series: | 结直肠肛门外科 |
| Subjects: | |
| Online Access: | https://jcas.gxmuyfy.cn/cn/wqll/paper.html?id=73&cateName=2023%E5%B9%B4%20%E7%AC%AC29%E5%8D%B7%20%E7%AC%AC6%E6%9C%9F |
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| Summary: | [Objectives] To explore the short-term effectiveness and safety of sacral nerve modulation (SNM) in the treatment of bladder-and-bowel dysfunction (BBD). [Methods] A retrospective analysis was conducted on the clinical data of 16 patients with BBD who underwent SNM between April 2021 and August 2023. The study included various presentations of BBD, such as constipation + bladder outlet obstruction (7 cases), fecal incontinence + bladder outlet obstruction (4 cases), constipation + urinary incontinence (2 cases), fecal incontinence + urinary incontinence (2 cases), constipation + overactive bladder (1 case). SNM was performed in two stages, with the second stage involving permanent stimulator implantation. The clinical baseline data was collected before the first stage surgery. The trial treatment period spanned the interval between the first and second stage surgeries. Shortterm improvement and adverse events were recorded and analyzed. The improvement of symptoms was evaluated using the Wexner fecal incontinence scale, Wexner constipation scale, and International Consultation on Incontinence Modular Questionnaire on Male/Female Lower Urinary Tract Symptoms long form. [Results] The average trial treatment period for 16 patients was (30.6±7.0) days, with all completing follow-up at baseline and the end of the trial treatment period. After the trial treatment period, 15 patients experienced more than 50% symptoms improvement. Fourteen patients proceeded to the second stage surgery, and 12 completed follow-up 6 months post-surgery. Two patients chose to remove the electrode, terminate this therapy, and completed followup within 6 months after surgery. Significant differences in the scores of each scale were observed at baseline, the end of the trial treatment period, and 6 months after the second stage surgery (P<0.05); the scores at 6 months after the second stage surgery was significantly lower than that at baseline (P<0.05). During follow-up, adverse events included 2 cases of wound infection, 1 case of delayed wound healing, and 1 case of electrode stretching leading to treatment failure and reimplantation. [Conclusion] SNM demonstrated satisfactory short-term effectiveness in treating carefully selected patients with BBD, with acceptable safety. |
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| ISSN: | 1674-0491 |