Does sacral nerve stimulation improve global pelvic function in women?

Colorectal Dis. 2013 Jul;15(7):848-57. doi: 10.1111/codi.12181.

Abstract

Aim: Many women undergoing sacral neuromodulation for faecal incontinence have coexisting pelvic floor dysfunction. We used a global pelvic-floor assessment questionnaire to evaluate the effect of sacral neuromodulation on non-bowel related symptomatology.

Method: The electronic Personnel Assessment Questionnaire - Pelvic Floor (ePAQ-PF) is a validated Web-based electronic pelvic floor questionnaire. Women with faecal incontinence underwent assessment using the ePAQ. Pre- and poststimulator data were analysed over a 4.5-year period.

Results: Forty-three women (mean age 56.5 years; median follow up 6.8 months) were included. All (100%) had urinary symptoms, 81.4% had vaginal symptoms and 85.7% described some sexual dysfunction. There was a significant improvement in faecal incontinence and in bowel-related quality of life (P < 0.005) as well as in irritable bowel syndrome (IBS)-related symptoms (P < 0.01) and in bowel-related sexual heath (P < 0.01). Symptoms of vaginal prolapse significantly improved (P = 0.05). There was also improvement in symptoms of overactive bladder (P = 0.005) and in urinary-related quality of life (P < 0.05). A global health improvement was reported in 58.1%, mainly in bowel evacuation (P < 0.01) and in vaginal pain and sensation (P < 0.05). In sexually active female patients, significant improvements in vaginal and bowel-related sexual health were seen (P < 0.005). Improvement in general sex life following stimulation was reported in 53.3%.

Conclusion: A Web-based electronic pelvic-floor assessment questionnaire has demonstrated global improvement in pelvic floor function in bowel, urinary, vaginal and sexual dimensions in women following sacral neuromodulation for faecal incontinence.

Keywords: Faecal incontinence; pelvic floor; questionnaire; sacral nerve stimulation.

MeSH terms

  • Electric Stimulation Therapy / methods*
  • Fecal Incontinence / complications
  • Fecal Incontinence / therapy*
  • Female
  • Humans
  • Implantable Neurostimulators
  • Middle Aged
  • Pelvic Floor Disorders / complications
  • Pelvic Floor Disorders / therapy*
  • Pelvic Organ Prolapse / complications
  • Pelvic Organ Prolapse / therapy*
  • Quality of Life
  • Sacrococcygeal Region
  • Sexual Dysfunction, Physiological / etiology
  • Sexual Dysfunction, Physiological / therapy
  • Spinal Nerves*
  • Surveys and Questionnaires
  • Treatment Outcome
  • Urinary Incontinence / complications
  • Urinary Incontinence / therapy*