Department of Digestive Surgery, Hôpital Saint-Antoine (AP/HP), Université Pierre et Marie Curie, Paris, France.
Colorectal Dis. 2010 Mar;12(3):247-53. doi: 10.1111/j.1463-1318.2009.01899.x. Epub 2009 Apr 13.
Before undergoing sacral nerve stimulation (SNS) for faecal incontinence (FI), patients are investigated with morphologic, dynamic and electrophysiologic tests. The purpose of our study was to evaluate their value in the selection of patients who may benefit most from neuromodulation.
If temporary stimulation resulted in a good objective response, a permanent neuromodulator was implanted. Patients were reviewed at 3 months and then at 6 monthly intervals. Asked by telephone, patient's satisfaction was described as good, satisfactory or poor.
Forty-five consecutive patients (41 females, median age 59 years) with FI (Wexner 16.1 +/- 2.9) underwent SNS. Temporary stimulation was successful in 32 (71)% patients. At a median follow-up of 33 months, the neuromodulator remained in place in 25 (55%) patients, two do whom switched it off, leaving 23 (51%) with a functioning neuromodulator. There was no statistically significant difference between the characteristics (including manometry, ultrasound and electrophysiology) of patients undergoing implantation (n = 32) or not (n = 13) and those with or without a functioning stimulator (n = 23: n = 13). In the 23 patients with a functioning stimulator the result was good in 12, satisfactory in five and poor in six. There was no statistically significant difference in the patient characteristics between those with a good result (n = 12) and the remainder (n = 32).
The findings suggest that investigation for FI does not facilitate patient selection for SNS and cannot be used to predict outcome.
在接受骶神经刺激（SNS）治疗大便失禁（FI）之前，患者需要接受形态学、动力学和电生理学检查。我们的研究目的是评估这些检查在选择最可能从神经调节中获益的患者方面的价值。
如果临时刺激产生了良好的客观反应，则植入永久性神经调节剂。患者在 3 个月和 6 个月时进行复查。通过电话询问，患者的满意度被描述为良好、满意或不满意。
45 例连续 FI 患者（41 例女性，中位年龄 59 岁）接受了 SNS 治疗。32 例（71%）患者的临时刺激成功。中位随访 33 个月后，25 例（55%）患者仍保留神经调节剂，其中 2 例关闭，23 例（51%）仍有功能的神经调节剂。接受植入（n = 32）或未接受植入（n = 13）的患者以及有或无功能刺激器的患者（n = 23：n = 13）之间的特征（包括测压、超声和电生理学）无统计学差异。在有功能刺激器的 23 例患者中，12 例结果良好，5 例满意，6 例不满意。功能良好的患者（n = 12）和其余患者（n = 32）之间的患者特征无统计学差异。
这些发现表明，FI 的检查并不能有助于 SNS 的患者选择，也不能用于预测结果。
