sacral nerve stimulation is effective in the treatment of faecal incontinence. however, 15 to 30%...

6
Sacral nerve stimulation is effective in the treatment of faecal incontinence. However, 15 to 30% of patients fail to respond post-implantation for unknown reasons. No factors are PREDICTIVE FACTORS FOR SUCCESSFUL SACRAL NERVE STIMULATION IN THE TREATMENT OF FAECAL INCONTINENCE: LESSONS FROM A COMPREHENSIVE TREATMENT ASSESSMENT Anne-Laure Roy, MD; Guillaume Gourcerol, MD, PhD; Jean-Francois Menard, MD; Francis Michot, MD, PhD; Anne-Marie Leroi, MD, PhD, and Valérie Bridoux, MD, PhD

Upload: emery-townsend

Post on 03-Jan-2016

219 views

Category:

Documents


0 download

TRANSCRIPT

Page 1: Sacral nerve stimulation is effective in the treatment of faecal incontinence.  However, 15 to 30% of patients fail to respond post-implantation for

Sacral nerve stimulation is effective in the treatment of faecal incontinence. However, 15 to 30% of patients fail to respond post-implantation for unknown reasons. No factors are predictive of secondary failures.

PREDICTIVE FACTORS FOR SUCCESSFUL SACRAL NERVE STIMULATION

IN THE TREATMENT OF FAECAL INCONTINENCE: LESSONS FROM A COMPREHENSIVE TREATMENT ASSESSMENT

Anne-Laure Roy, MD; Guillaume Gourcerol, MD, PhD; Jean-Francois Menard, MD; Francis Michot, MD, PhD; Anne-Marie Leroi, MD, PhD, and Valérie Bridoux, MD, PhD

Page 2: Sacral nerve stimulation is effective in the treatment of faecal incontinence.  However, 15 to 30% of patients fail to respond post-implantation for

• Aims of the study

1. Investigate the effect of a three-year sacral nerve stimulation treatment of faecal continence.

2. Identify specific predictive factors from the pre- and per-treatment assessments for the mid-term success of SNS.

Page 3: Sacral nerve stimulation is effective in the treatment of faecal incontinence.  However, 15 to 30% of patients fail to respond post-implantation for

IMPLANTS 60 Pre-implantation assessment

Page 4: Sacral nerve stimulation is effective in the treatment of faecal incontinence.  However, 15 to 30% of patients fail to respond post-implantation for

IMPLANTS 45

Post-implantation assessment

Page 5: Sacral nerve stimulation is effective in the treatment of faecal incontinence.  However, 15 to 30% of patients fail to respond post-implantation for

• Effect of sacral nerve stimulation at the 3 year follow-up

60 patients

33 patientsSuccessful outcome

ITT = 31.7%PP = 55%

22 patientsUnsuccessful outcome

ITT = 24.7%PP = 36.7%

5 missing severity score

12 patientsDevice failures

7 patientsexplanted/

switched off device

3 patientswithdrew from study

Page 6: Sacral nerve stimulation is effective in the treatment of faecal incontinence.  However, 15 to 30% of patients fail to respond post-implantation for

• Why did some patients show no improvement post-implantation?

• Predictive factors for the mid-term success of sacral nerve stimulation