Double-blind placebo-controlled crossover study of sacral nerve stimulation for idiopathic constipation

Kenefick, N J; Vaizey, C. J.; Cohen, C. Richard G.; Nicholls, R. J.; Kamm, Michael A.

doi:10.1046/j.1365-2168.2002.02278.x

Cited by 104 publications

(101 citation statements)

References 5 publications

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“…18,19 At this time, anomanometric study is not recommended for SCI patients before NBS surgeries. 20 However, the utility of ano-manometric investigation either to better select SCI patients for SNM or to better comprehend SNM's mechanism of action in NBS is not yet well known.…”

Section: Discussionmentioning

confidence: 99%

Clinical concomitant benefits on pelvic floor dysfunctions after sacral neuromodulation in patients with incomplete spinal cord injury

et al. 2011

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Objectives: To assess the concomitant clinical improvement in incomplete spinal cord injury patients (SCIPs) suffering from neurogenic bowel symptoms (NBSs), neurogenic lower urinary tract symptoms (NLUTSs) and neurogenic erectile dysfunction (NED) using sacral neuromodulation (SNM) for NBSs and NLUTSs. Methods: Seventy-five SCIPs were selected. Before and during the follow-ups post-SNM, NLUTSs and NBSs were detected mainly through specific diaries. Erectile function was assessed using the International Index of Erectile Function composed of 5 questions (IIEF5). Quality of life (QoL) was measured with the Short Form 36 Health Survey questionnaire (SF-36). During the first stage, in which a permanent electrode was inserted percutaneously into the third sacral foramina and stimulated using an external generator, patients with NBSs or NLUTSs were required to improve their symptoms by at least 50% compared with baseline before proceeding to the second stage in which the generator was placed in the patient's buttock. NED patients needed to increase their IIEF5 score by at least 25% compared with baseline (evaluated initially 3 months after the second stage) in order to continue follow-up. Results: Fourteen out of 37 subjects who manifested two functional pelvic dysfunctions at baseline maintained notable clinical improvement in two pelvic functions (median follow-up 43 years). Six had non-obstructive retention (NOR) and NED, six double incontinence, and two constipation with NOR. In the general and mental health domains of the SF-36, all patients improved their scores by at least 20% compared with baseline. Conclusions: SNM may be beneficial to selected incomplete SCIP with concomitant pelvic functional disturbances.

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Section: Discussionmentioning

confidence: 99%

Clinical concomitant benefits on pelvic floor dysfunctions after sacral neuromodulation in patients with incomplete spinal cord injury

et al. 2011

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“…Literature reported discordance and varying results with regard to anorectal findings after permanent SNM in patients suffering from bowel dysfunctions. 18,19 At this time, the possible effects of SNM on colonrectal transport are still unclear. 18 Still to be resolved is the contribution and importance of the complex multisynaptic mechanisms of the multiple nerves within the sacral plexus, as well as the enteric nerves, the spinal cord, the brainstem and the cerebral cortex and their changes during SNM.…”

Section: Discussionmentioning

confidence: 99%

“…18,19 At this time, the possible effects of SNM on colonrectal transport are still unclear. 18 Still to be resolved is the contribution and importance of the complex multisynaptic mechanisms of the multiple nerves within the sacral plexus, as well as the enteric nerves, the spinal cord, the brainstem and the cerebral cortex and their changes during SNM. The multiple and complex mechanism of actions of SNM on all pelvic organ functions is highlighted by a recent study on patients with partial SCI; most of these patients suffered from concomitant bowel, bladder and sexual dysfunctions due to the same neurological etiology, and showed a remarkable clinical improvement in neurogenic lower urinary tract symptoms and sexual function in the medium and long term.…”

Section: Discussionmentioning

confidence: 99%

Clinical outcome of sacral neuromodulation in incomplete spinal cord-injured patients suffering from neurogenic bowel dysfunctions

et al. 2009

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Study design: Retrospective study. Objectives: Efficacy and safety of sacral neuromodulation (SNM) in incomplete spinal cord-injured patients (SCIPs) affected by chronic neurogenic bowel symptoms (NBSs). Setting: Neurourology Department. Primary to tertiary care. Methods: Retrospective non-blinded study without controls. Thirty-nine SCIPs were submitted to temporary stimulation for NBS. Permanent implantation was carried out if both their NBSs improved and the Wexner questionnaire scores were reduced by at least 50% during the first stage compared with that at baseline. Outcome measures included episodes of fecal incontinence and number of evacuations per week, as well as the Wexner score and the Short Form 36 (SF-36) Health Survey questionnaire. Results: Twenty-three SCIPs were submitted to definitive SNM, maintaining their clinical benefits after permanent implantation with a median follow-up of 38 months. The length of time since neurological diagnosis to SNM therapy represents the only factor related to the success of the implantation, Po0.05. In subjects with constipation (12), the median number of evacuations shifted from 1.65 to 4.98 per week, whereas the Wexner score changed from 19.91 to 6.82 in the final checkup with Po0.05. In subjects with fecal incontinence (11), the median number of episodes per week in the final follow-up was 1.32 compared with 4.55 pre-SNM. The general and mental health of both groups was measured with the SF-36 questionnaire and consistently showed statistical improvement (Po0.05). Anorectal manometry showed no important variation compared with baseline. There were no major complications. Conclusions: SNM therapy should be considered for the treatment of NBS for select patients with incomplete spinal cord injury when conservative treatments fail.

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“…Использование макрогола, бисакодила, гли-цериновых суппозиториев, фосфата натрия и клизмы с арахисовым маслом также является обычной практикой перед использованием относительно инновационных агентов [5][6][7][8][9][10][11][12][13][14][15]. В различных источниках с переменной эффективностью обсуждаются нефармакологические вме-шательства, такие как ритуализирующие привычки для кишечника, терапия биологической обратной связи, пове-денческая терапия, электростимуляция мышц таза, когни-тивная терапия и хирургические пособия на толстой кишке у пациентов с хроническим запором [16][17][18][19].…”

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Prukalopride in the Treatment of Chronic Constipation

Плотникова¹,

Грачева²

2017

Med. sov.

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Double-blind placebo-controlled crossover study of sacral nerve stimulation for idiopathic constipation

Cited by 104 publications

References 5 publications

Clinical concomitant benefits on pelvic floor dysfunctions after sacral neuromodulation in patients with incomplete spinal cord injury

Clinical concomitant benefits on pelvic floor dysfunctions after sacral neuromodulation in patients with incomplete spinal cord injury

Clinical outcome of sacral neuromodulation in incomplete spinal cord-injured patients suffering from neurogenic bowel dysfunctions

Prukalopride in the Treatment of Chronic Constipation

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