Risk factors for complications following sacral neuromodulation for faecal incontinence: Long‐term follow‐up

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Auteurs principaux: Rachel Gefen, Victor Strassmann, Felice De Stefano Hernandez, Zoe Garoufalia, Nir Horesh, Sameh Hany Emile, Giovanna Da Silva, Steven Wexner
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Publié: Wiley 2024
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author Rachel Gefen
Victor Strassmann
Felice De Stefano Hernandez
Zoe Garoufalia
Nir Horesh
Sameh Hany Emile
Giovanna Da Silva
Steven Wexner
author_facet Rachel Gefen
Victor Strassmann
Felice De Stefano Hernandez
Zoe Garoufalia
Nir Horesh
Sameh Hany Emile
Giovanna Da Silva
Steven Wexner
Rachel Gefen
Victor Strassmann
Felice De Stefano Hernandez
Zoe Garoufalia
Nir Horesh
Sameh Hany Emile
Giovanna Da Silva
Steven Wexner
collection Wiley Open Access
contents Risk factors for complications following sacral neuromodulation for faecal incontinence: Long‐term follow‐up Rachel Gefen Victor Strassmann Felice De Stefano Hernandez Zoe Garoufalia Nir Horesh Sameh Hany Emile Giovanna Da Silva Steven Wexner Colorectal Disease AbstractAimSacral neuromodulation (SNM) has become a standard surgical treatment for faecal incontinence (FI). Prior studies have reported various adverse events of SNM, including suboptimal therapeutic response, infection, pain, haematoma, and potential need for redo SNM. The aim of this study was to identify the risk factors associated with long‐term complications of SNM.MethodThis retrospective cohort reviewed patients who underwent two‐stage SNM for FI at our institution between 2011–2021. Preoperative baseline characteristics and follow‐up were obtained from the medical record and/or by telephone interview. Management and outcome of each postoperative event were evaluated by univariate and multivariate regression analyses.ResultsA total of 291 patients (85.2% female) were included in this study. Postoperative complications were recorded in 219 (75.2%) patients and 154 (52.9%) patients required surgical intervention to treat complications. The most common postoperative event was loss of efficacy (46.4%). Other common adverse events were problems at the implant site (pain, infection, etc.) in 16.5% and pain during stimulation in 11.7%. Previous vaginal delivery (OR 2.74, p = 0.003) and anal surgery (OR = 2.46, p = 0.039) were independent predictors for complications. Previous colorectal (OR = 2.04, p = 0.026) and anal (OR = 1.98, p = 0.022) surgery and history of irritable bowel syndrome (IBS) (OR = 3.49, p = 0.003) were independent predictors for loss of efficacy.ConclusionPostoperative adverse events are frequently recorded after SNM. Loss of efficacy is the most common. Previous colorectal or anal surgery, vaginal delivery, and IBS are independent risk factors for complications. 10.1111/codi.17092 http://creativecommons.org/licenses/by/4.0/
doi_str_mv 10.1111/codi.17092
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institution Wiley Open Access
license_str_mv http://creativecommons.org/licenses/by/4.0/
publishDate 2024
publisher Wiley
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spellingShingle Risk factors for complications following sacral neuromodulation for faecal incontinence: Long‐term follow‐up
Rachel Gefen
Victor Strassmann
Felice De Stefano Hernandez
Zoe Garoufalia
Nir Horesh
Sameh Hany Emile
Giovanna Da Silva
Steven Wexner
Colorectal Disease
Risk factors for complications following sacral neuromodulation for faecal incontinence: Long‐term follow‐up Rachel Gefen Victor Strassmann Felice De Stefano Hernandez Zoe Garoufalia Nir Horesh Sameh Hany Emile Giovanna Da Silva Steven Wexner Colorectal Disease AbstractAimSacral neuromodulation (SNM) has become a standard surgical treatment for faecal incontinence (FI). Prior studies have reported various adverse events of SNM, including suboptimal therapeutic response, infection, pain, haematoma, and potential need for redo SNM. The aim of this study was to identify the risk factors associated with long‐term complications of SNM.MethodThis retrospective cohort reviewed patients who underwent two‐stage SNM for FI at our institution between 2011–2021. Preoperative baseline characteristics and follow‐up were obtained from the medical record and/or by telephone interview. Management and outcome of each postoperative event were evaluated by univariate and multivariate regression analyses.ResultsA total of 291 patients (85.2% female) were included in this study. Postoperative complications were recorded in 219 (75.2%) patients and 154 (52.9%) patients required surgical intervention to treat complications. The most common postoperative event was loss of efficacy (46.4%). Other common adverse events were problems at the implant site (pain, infection, etc.) in 16.5% and pain during stimulation in 11.7%. Previous vaginal delivery (OR 2.74, p = 0.003) and anal surgery (OR = 2.46, p = 0.039) were independent predictors for complications. Previous colorectal (OR = 2.04, p = 0.026) and anal (OR = 1.98, p = 0.022) surgery and history of irritable bowel syndrome (IBS) (OR = 3.49, p = 0.003) were independent predictors for loss of efficacy.ConclusionPostoperative adverse events are frequently recorded after SNM. Loss of efficacy is the most common. Previous colorectal or anal surgery, vaginal delivery, and IBS are independent risk factors for complications. 10.1111/codi.17092 http://creativecommons.org/licenses/by/4.0/
title Risk factors for complications following sacral neuromodulation for faecal incontinence: Long‐term follow‐up
topic Colorectal Disease
url https://onlinelibrary.wiley.com/doi/10.1111/codi.17092