Sacral neuromodulation for faecal incontinence following obstetric sphincter injury – outcome of percutaneous nerve evaluation
Abstract Aim The purpose of this study was to assess the efficacy of percutaneous nerve evaluation ( PNE ) in women with faecal incontinence ( FI ) following obstetric anal sphincter injury and to relate the outcomes to baseline factors, with special emphasis on the extent of the sphincter defect. M...
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crwiley:10.1111/codi.13472 2024-09-09T19:58:37+00:00 Sacral neuromodulation for faecal incontinence following obstetric sphincter injury – outcome of percutaneous nerve evaluation Rydningen, M. B. Dehli, T. Wilsgaard, T. Lindsetmo, R. O. Kumle, M. Stedenfeldt, M. Norderval, S. 2017 http://dx.doi.org/10.1111/codi.13472 https://api.wiley.com/onlinelibrary/tdm/v1/articles/10.1111%2Fcodi.13472 https://onlinelibrary.wiley.com/doi/pdf/10.1111/codi.13472 en eng Wiley http://onlinelibrary.wiley.com/termsAndConditions#vor Colorectal Disease volume 19, issue 3, page 274-282 ISSN 1462-8910 1463-1318 journal-article 2017 crwiley https://doi.org/10.1111/codi.13472 2024-06-18T04:12:32Z Abstract Aim The purpose of this study was to assess the efficacy of percutaneous nerve evaluation ( PNE ) in women with faecal incontinence ( FI ) following obstetric anal sphincter injury and to relate the outcomes to baseline factors, with special emphasis on the extent of the sphincter defect. Method This was a prospective study at a tertiary colorectal referral unit at the University Hospital of North Norway conducted from 2012 to 2014. Sixty‐three women underwent a 3‐week PNE using a tined lead and the Verify ® external neurostimulator. The primary outcome was efficacy, defined as the percentage reduction in weekly FI episodes, and patients with a reduction of 50% or more were defined as responders. Baseline factors affecting the primary outcome were explored. Sphincter defects were classified with a validated three‐dimensional endoanal ultrasound defect score. Results Fifty‐six (89%) of the 63 women were responders with a reduction in weekly FI episodes of 94.5%, from a median (interquartile range) of 4.8 (2.0–11.0) to 0.5 (0–2.0) ( P < 0.001). Twenty‐nine (52%) reported no weekly FI episodes, and urgency episodes disappeared in 18 (32%). In the multivariable linear regression model, efficacy was related to concomitant urinary incontinence ( P = 0.04), body mass index ( BMI ) ( P = 0.03) and pain during PNE ( P = 0.046) but not to the extent of the sphincter defect ( P = 0.1). Responders had a higher St Mark's score than nonresponders ( P = 0.046). Conclusions The vast majority of women had successful PNE tests. Responders had higher baseline St Mark's scores than nonresponders. Efficacy was related to concomitant urinary incontinence, BMI and pain, not to the extent of the sphincter defect. Article in Journal/Newspaper North Norway Wiley Online Library Norway Colorectal Disease 19 3 274 282 |
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Wiley Online Library |
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English |
description |
Abstract Aim The purpose of this study was to assess the efficacy of percutaneous nerve evaluation ( PNE ) in women with faecal incontinence ( FI ) following obstetric anal sphincter injury and to relate the outcomes to baseline factors, with special emphasis on the extent of the sphincter defect. Method This was a prospective study at a tertiary colorectal referral unit at the University Hospital of North Norway conducted from 2012 to 2014. Sixty‐three women underwent a 3‐week PNE using a tined lead and the Verify ® external neurostimulator. The primary outcome was efficacy, defined as the percentage reduction in weekly FI episodes, and patients with a reduction of 50% or more were defined as responders. Baseline factors affecting the primary outcome were explored. Sphincter defects were classified with a validated three‐dimensional endoanal ultrasound defect score. Results Fifty‐six (89%) of the 63 women were responders with a reduction in weekly FI episodes of 94.5%, from a median (interquartile range) of 4.8 (2.0–11.0) to 0.5 (0–2.0) ( P < 0.001). Twenty‐nine (52%) reported no weekly FI episodes, and urgency episodes disappeared in 18 (32%). In the multivariable linear regression model, efficacy was related to concomitant urinary incontinence ( P = 0.04), body mass index ( BMI ) ( P = 0.03) and pain during PNE ( P = 0.046) but not to the extent of the sphincter defect ( P = 0.1). Responders had a higher St Mark's score than nonresponders ( P = 0.046). Conclusions The vast majority of women had successful PNE tests. Responders had higher baseline St Mark's scores than nonresponders. Efficacy was related to concomitant urinary incontinence, BMI and pain, not to the extent of the sphincter defect. |
format |
Article in Journal/Newspaper |
author |
Rydningen, M. B. Dehli, T. Wilsgaard, T. Lindsetmo, R. O. Kumle, M. Stedenfeldt, M. Norderval, S. |
spellingShingle |
Rydningen, M. B. Dehli, T. Wilsgaard, T. Lindsetmo, R. O. Kumle, M. Stedenfeldt, M. Norderval, S. Sacral neuromodulation for faecal incontinence following obstetric sphincter injury – outcome of percutaneous nerve evaluation |
author_facet |
Rydningen, M. B. Dehli, T. Wilsgaard, T. Lindsetmo, R. O. Kumle, M. Stedenfeldt, M. Norderval, S. |
author_sort |
Rydningen, M. B. |
title |
Sacral neuromodulation for faecal incontinence following obstetric sphincter injury – outcome of percutaneous nerve evaluation |
title_short |
Sacral neuromodulation for faecal incontinence following obstetric sphincter injury – outcome of percutaneous nerve evaluation |
title_full |
Sacral neuromodulation for faecal incontinence following obstetric sphincter injury – outcome of percutaneous nerve evaluation |
title_fullStr |
Sacral neuromodulation for faecal incontinence following obstetric sphincter injury – outcome of percutaneous nerve evaluation |
title_full_unstemmed |
Sacral neuromodulation for faecal incontinence following obstetric sphincter injury – outcome of percutaneous nerve evaluation |
title_sort |
sacral neuromodulation for faecal incontinence following obstetric sphincter injury – outcome of percutaneous nerve evaluation |
publisher |
Wiley |
publishDate |
2017 |
url |
http://dx.doi.org/10.1111/codi.13472 https://api.wiley.com/onlinelibrary/tdm/v1/articles/10.1111%2Fcodi.13472 https://onlinelibrary.wiley.com/doi/pdf/10.1111/codi.13472 |
geographic |
Norway |
geographic_facet |
Norway |
genre |
North Norway |
genre_facet |
North Norway |
op_source |
Colorectal Disease volume 19, issue 3, page 274-282 ISSN 1462-8910 1463-1318 |
op_rights |
http://onlinelibrary.wiley.com/termsAndConditions#vor |
op_doi |
https://doi.org/10.1111/codi.13472 |
container_title |
Colorectal Disease |
container_volume |
19 |
container_issue |
3 |
container_start_page |
274 |
op_container_end_page |
282 |
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1809929649489182720 |