Observation Of Sacral Neuromodulation For Severe Idiopathic Constipation

Aim Constipation has become increasingly prevalent,and traditional treatment methods rarely cure severe constipation.This study investigated the curative effect of sacral neuromodulation(SNM)for constipation.Method Constipation patients who failed traditional treatment for at least 1 year and who visited the First Affliated Hospital of AFMU,underwent relevant exams and percutaneous nerve evaluation(PNE).When they experienced a good response to PNE(≥50%)after 2 or 3weeks,they underwent permanent SNS treatment.The patients underwent relative test specifications at every study time point.Result In total,21 patients underwent PNE.Eighteen patients experienced significant improvement with PNE(≥50%),and 16 patients received permanent SNM.Among these 16 patients,2 patients experienced constipation again after SNM treatment for 3 and 6 months,separately.In 14 patients(66.7%),treatment was continuously effective.The autonomic stool frequency per week increased from 1.53 to 6.73(P<0.001),the autonomic stool days per week increased from 1.53 to 4.53(P<0.001),the defecation time(min)decreased from 20.2 to 7.81(P<0.001),the Cleveland clinic constipation score(CCCS)decreased from 20.3 to 10.8(P<0.001),and the visual analogue scale(VAS)score increased from 15.0 to 74.4(P<0.001).The values of the eight parts of the SF-36 questionnaire changed.The mean scores for physical functioning increased from 81.3 to86.3(P=0.034),body pain increased from 58.6 to 70.3(P=0.005),vitality increased from 61.3 to 67.0(P=0.037),role-emotional increased from 42.2 to 69.0(P=0.001),role-physical increased from 63.3to 76.7(P=0.041),general health increased from 45.3 to 57.4(P=0.004),social functioning increased from 62.5 to 72.5(P=0.005)and mental health increased from 60.2 to 69.3(P=0.001),respectively.Conclusion SNM treatment has obvious effects on severe constipation and is a safe treatment.Bilateral PNE implantation may be a useful treatment option for those who experience a positive effect from SNM treatment.