Secondary changes in bowel function after successful treatment of voiding symptoms with neuromodulation

Abstract

Studies have indicated that neuromodulation improves FI in carefully selected patients. The impact on other bowel conditions, including IBS, is unclear. Since voiding and bowel symptoms often coexist, it is crucial to fully evaluate all potential treatment benefits.

Improvement of bowel dysfunction with sacral neuromodulation for refractory urge urinary incontinence

“…One retrospective study [2] with long-term follow-up noted a 58.6% rate of bowel complaints in a mixed male and female population with varying urologic conditions, including urinary urgency and frequency, UUI, and urinary retention. This is similar to the overall 64.3% prevalence in the recent, comprehensive, prospective study [21] mentioned previously. However, further review of the literature, including other recent publications [19,20] on concomitant benefits of SNS on bowel function, revealed no estimates of the prevalence of concurrent bowel dysfunction in refractory UUI.…”

“…A large study [6] of the prevalence of anal incontinence with urinary incontinence and pelvic organ prolapse found that in women without prolapse, 24% with unspecified urinary incontinence had anal incontinence, and more specifically, 29% with detrusor instability had anal incontinence. This is notably lower than the 80% rate of FI in a sample of men and women with urinary urgency/frequency with or without UUI, as described in a recent prospective study [21] investigating bowel dysfunction with all urologic SNS indications. The 83% prevalence of fecal incontinence with UUI observed in the current study agrees with this latter observation, likely due to a more severe pathology existing in refractory UUI patients receiving SNS.…”

“…Recently, SNS has demonstrated [19][20][21] benefit in small numbers of patients with combined disorders of both UUI and bowel dysfunction. The current study confirms these findings with a larger sample of pure UUI patients and similar battery of validated questionnaires.…”

“…Recently studies investigating secondary effects of SNS for urinary indications noted [19][20][21] high levels of concomitant bowel dysfunction. Additionally, secondary improvements in bowel function with SNS for urinary indications have been reported [19][20][21] both retrospectively and prospectively.…”

“…Additionally, secondary improvements in bowel function with SNS for urinary indications have been reported [19][20][21] both retrospectively and prospectively. The objectives of this study were to prospectively describe urinary and bowel symptoms, and quality of life (QOL) in a sample of women undergoing SNS for refractory UUI and subsequently determine the effects of SNS on both urinary and bowel symptoms, and QOL.…”