Resource implications of running a sacral neuromodulation service: a 10-year experience.

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  • Author(s): McMullin CM;McMullin CM; Jadav AM; Hanwell C; Brown SR
  • Source:
    Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland [Colorectal Dis] 2014 Sep; Vol. 16 (9), pp. 719-22.
  • Publication Type:
    Evaluation Study; Journal Article
  • Language:
    English
  • Additional Information
    • Source:
      Publisher: Blackwell Science Ltd Country of Publication: England NLM ID: 100883611 Publication Model: Print Cited Medium: Internet ISSN: 1463-1318 (Electronic) Linking ISSN: 14628910 NLM ISO Abbreviation: Colorectal Dis Subsets: MEDLINE
    • Publication Information:
      Original Publication: Oxford, UK : Blackwell Science Ltd.,
    • Subject Terms:
      Lumbosacral Plexus*; Electric Stimulation Therapy/*economics ; Fecal Incontinence/*therapy ; Hospital Costs/*statistics & numerical data ; Implantable Neurostimulators/*economics; Databases, Factual ; Electric Stimulation Therapy/instrumentation ; Electric Stimulation Therapy/methods ; Fecal Incontinence/economics ; Female ; Follow-Up Studies ; Humans ; Male ; Quality of Life ; Treatment Outcome ; United Kingdom
    • Abstract:
      Aim: In this study we reviewed our 10-year experience of the medium- to long-term success of sacral nerve stimulation (SNS) for faecal incontinence, with particular reference to the resource implications of running such a service.
      Method: All patients treated with permanent SNS implants for faecal incontinence from 2001 to 2012 were identified from a prospective database. The patients underwent follow up at 3 and 6 months, with annual review thereafter. They were divided into four groups: group 1, patients optimized after two reviews; group 2, patients optimized after further review; group 3, patients who failed to reach a satisfactory state; and group 4, patients who had a good initial result with subsequent failure.
      Results: Eighty-five patients underwent permanent SNS with a median follow up of 24 (range: 3-108) months. Group 1 included 30 (35%) patients; group 2 included 27 (32%) patients [median of two (range: 2-6) additional visits]; group 3 included 18 (21%) patients [median of six (range: 3-10) additional visits]; and group 4 included 10 (12%) patients [median interval to failure was 54 (range: 24-84) months]. Twenty-seven per cent of our patients had an unsatisfactory outcome and the cost of follow up for these patients was £36,854 (48.7% of the total follow-up costs).
      Conclusion: The study highlights the significant resource implications of running an SNS service with a large proportion of patients requiring prolonged review, with more than one-quarter having an unsatisfactory outcome at a substantial cost.
      (Colorectal Disease © 2014 The Association of Coloproctology of Great Britain and Ireland.)
    • Contributed Indexing:
      Keywords: Constipation; faecal incontinence; sacral nerve stimulation
    • Publication Date:
      Date Created: 20140617 Date Completed: 20150512 Latest Revision: 20191210
    • Publication Date:
      20250114
    • Accession Number:
      10.1111/codi.12686
    • Accession Number:
      24930568