Department of Colorectal Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands.
Colorectal Dis. 2012 Apr;14(4):508-14. doi: 10.1111/j.1463-1318.2011.02678.x.
Sacral nerve modulation is a well accepted method for the treatment of defaecation disorders and voiding dysfunction. Results of sacral nerve modulation in patients with spinal cord lesions are not well assessed, but preliminary results look poor. Therefore, the purpose of this study was to assess the effectiveness of sacral nerve modulation for defaecation disorders and voiding dysfunction in patients with spina bifida.
Consecutive patients with spina bifida suffering from a myelomeningocele and combined faecal and urinary functional disorders that were eligible for peripheral nerve evaluation (PNE) were studied. A permanent sacral nerve modulation implantation was performed after successful PNE.
Ten patients (four female) were included in this study with a median age of 26.4 (range 11.1-41.0) years. In two the PNE was not possible. The median faecal incontinence days (6.0 vs 3.5) and episodes (8.5 vs 3.5) per 21 days decreased significantly during the 3-week period of PNE (P = 0.033). Only 3/10 (30%) patients had a more than 50% improvement and proceeded to a permanent sacral nerve modulation implantation. In one patient it was not possible to perform the permanent implant.
Preliminary results of sacral nerve modulation in a subgroup of spina bifida patients with combined faecal and urinary functional disorders look promising, but long-term results in larger patient groups need to be studied.
骶神经调节是治疗排便障碍和排尿功能障碍的一种公认方法。骶神经调节在脊髓损伤患者中的效果尚未得到很好的评估，但初步结果看起来并不理想。因此，本研究旨在评估骶神经调节对伴有脊髓脊膜膨出的排便和排尿功能障碍患者的有效性。
连续纳入患有脊髓脊膜膨出且伴有粪便和尿液功能障碍的患者进行外周神经评估（PNE）。PNE 成功后行永久性骶神经调节植入术。
本研究共纳入 10 例患者（4 例女性），平均年龄 26.4 岁（范围 11.1-41.0 岁）。其中 2 例 PNE 不可行。在 PNE 的 3 周内，排便失禁天数（6.0 天比 3.5 天）和排便次数（8.5 次比 3.5 次）显著减少（P=0.033）。仅 3/10（30%）例患者的改善程度超过 50%，并进行了永久性骶神经调节植入。1 例患者无法进行永久性植入。
骶神经调节在伴有粪便和尿液功能障碍的脊髓脊膜膨出患者亚组中的初步结果令人鼓舞，但需要在更大的患者群体中研究长期结果。
