• Annals of surgery · Apr 2022

    Multicenter Study

    Ten-year Evaluation of a Large Retrospective Cohort Treated by Sacral Nerve Modulation for Fecal Incontinence: Results of a French Multicenter Study.

    • Charlotte Desprez, Henri Damon, Guillaume Meurette, Diane Mege, Jean-Luc Faucheron, Charlène Brochard, Elsa Lambrescak, Guillaume Gourcerol, Francois Mion, Vincent Wyart, Igor Sielezneff, Laurent Siproudhis, Isabelle Etienney, Nadine Ajamie, Paul-Antoine Lehur, Thomas Duflot, Valérie Bridoux, Anne-Marie Leroi, and Club NEMO.
    • Department of Digestive Physiology, Rouen, France.
    • Ann. Surg. 2022 Apr 1; 275 (4): 735-742.

    ObjectiveThe aim of this study was to assess the effectiveness of sacral nerve modulation (SNM) in a large cohort of patients implanted for at least 10 years, quantify adverse event rates, and identify predictive factors of long-term success.Summary Background DataFew studies have evaluated the long-term success of SNM.MethodsData collected prospectively from patients implanted for fecal incontinence (FI) in 7 French centers between January 1998 and December 2008 were retrospectively analyzed. Patient FI severity scores were assessed before and 10 years after implantation. The main evaluation criterion was the success of SNM defined by the continuation of the treatment without additional therapies. The secondary evaluation criteria were the rate of device revisions and explantations. Preoperative predictors of success at 10 years were sought.ResultsOf the 360 patients (27 males, mean age: 59 ± 12 years) implanted for FI, 162 (45%) had a favorable outcome 10 years post-implantation, 115 (31.9%) failed, and 83 (23.1%) were lost to follow-up. The favorable outcome derived from the time-to-event Kaplan-Meier curve at 10 years was 0.64 (95% CI 0.58-0.69). FI severity scores were significantly better 10 years post-implantation compared to preimplantation (7.4 ± 4.3 vs 14.0 ± 3.2; P < 0.0001). During the 10-year follow-up, 233 patients (64.7%) had a surgical revision and 94 (26.1%) were explanted. A history of surgery for FI and sex (male) were associated with an increased risk of an unfavorable outcome.ConclusionsLong-term efficacy was maintained in approximately half of the FI patients treated by SNM at least 10 years post-implantation.Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.

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