Clinical Efficacy of Sacral Neuromodulation for Fecal Incontinence Across Multiple Etiologies: A Single-Center Study

IF 3.7 3区医学 Q2 CLINICAL NEUROLOGY

Neuromodulation Pub Date : 2026-10-01 Epub Date: 2026-06-24 DOI:10.1016/j.neurom.2026.05.012

Peirui Wu MD, Tianming Ma MD, PhD, Qinxian Huang MD, MSc, Zhengyu Xian MD, PhD, Li Lu MD, PhD

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引用次数: 0

Abstract

Objective

This study aimed to evaluate the clinical outcomes of sacral neuromodulation (SNM) for fecal incontinence (FI) caused by diverse etiologies.

Materials and Methods

This retrospective study, conducted between April 2021 and December 2024, analyzed 34 consecutive patients with FI who underwent SNM. Preoperative examinations included high-resolution anorectal manometry, magnetic resonance imaging, and endoscopy. Symptom severity was assessed using the Wexner or low anterior resection syndrome (LARS) score, and quality of life was evaluated using the Fecal Incontinence Quality of Life scores (FIQL) pre- and postoperatively.

Results

The cohort included 14 women and 20 men with a median age of 52 years and a median FI duration of five years. Etiologies included LARS (n = 11), neurogenic bowel (n = 9), congenital malformations (n = 5), idiopathic FI (n = 3), and trauma- or radiation-related FI (n = 6). After successful lead implantation, >50% symptom relief was achieved in 29 patients (85.3%) during the testing phase, and 27 patients (79.4%) subsequently underwent permanent implantable pulse generator implantation. During a median follow-up of 32 months, Wexner scores decreased significantly from baseline (18.1 ± 2.3) to 6.6 ± 5.4 (testing phase), 5.3 ± 2.7 (six months), 8.8 ± 2.6 (12 months), and 8.2 ± 1.5 (24 months) (all p < 0.001). Significant improvements also were observed in the FIQL domains for lifestyle, coping/behavior, and depression (p < 0.05), whereas the embarrassment domain remained unchanged. Reported complications included surgical site infections (n = 2), delayed wound healing (n = 1), and one case of late efficacy that was successfully managed with device revision.

Conclusion

SNM provides safe, effective, and sustained relief in symptoms and improvements in quality of life for patients with FI across a spectrum of complex etiologies.

Clinical Trial Registration

The Chinese Clinical Trial Registry registration number for the study is ChiCTR2100054268.

查看原文本刊更多论文

骶神经调节治疗多种病因的大便失禁的临床疗效：一项单中心研究。

目的：评价骶神经调节（SNM）治疗多种病因引起的大便失禁（FI）的临床效果。材料和方法：这项回顾性研究于2021年4月至2024年12月进行，分析了34例连续接受SNM治疗的FI患者。术前检查包括高分辨率肛门直肠测压、磁共振成像和内窥镜检查。使用Wexner或低前切除术综合征（LARS）评分评估症状严重程度，使用粪便失禁生活质量评分（FIQL）评估术前和术后的生活质量。结果：队列包括14名女性和20名男性，中位年龄为52岁，中位FI持续时间为5年。病因包括LARS （n = 11）、神经源性肠（n = 9）、先天性畸形（n = 5）、特发性FI （n = 3）和创伤或辐射相关FI （n = 6）。导联植入成功后，29例患者（85.3%）在测试阶段症状缓解了50%，27例患者（79.4%）随后进行了永久性植入式脉冲发生器植入。在中位随访32个月期间，Wexner评分从基线（18.1±2.3）降至6.6±5.4（测试期）、5.3±2.7（6个月）、8.8±2.6（12个月）和8.2±1.5（24个月）（均p < 0.001）。在生活方式、应对/行为和抑郁的FIQL领域也观察到显著改善（p < 0.05），而尴尬领域保持不变。报告的并发症包括手术部位感染（n = 2），伤口愈合延迟（n = 1），以及一例通过器械翻修成功管理的晚期疗效。结论：SNM为各种复杂病因的FI患者提供了安全、有效和持续的症状缓解和生活质量改善。临床试验注册：本研究中国临床试验注册中心注册号为ChiCTR2100054268。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Neuromodulation 医学-临床神经学

CiteScore

6.40

自引率

3.60%

发文量

978

审稿时长

54 days

期刊介绍： Neuromodulation: Technology at the Neural Interface is the preeminent journal in the area of neuromodulation, providing our readership with the state of the art clinical, translational, and basic science research in the field. For clinicians, engineers, scientists and members of the biotechnology industry alike, Neuromodulation provides timely and rigorously peer-reviewed articles on the technology, science, and clinical application of devices that interface with the nervous system to treat disease and improve function.