Fecal incontinence (FI) is an involuntary passage of fecal matter which can have a significant impact on a patient's quality of life. Many modalities of treatment exist for FI. Sacral nerve stimulation is a well-established treatment for FI.
Given the increased need of magnetic resonance imaging (MRI) for diagnostics, the InterStim which was previously used in sacral nerve stimulation was limited by MRI incompatibility. Medtronic MRI-compatible InterStim was approved by the United States Food and Drug Administration in August 2020 and has been widely used.
To evaluate the efficacy, outcomes and complications of the MRI-compatible InterStim.
Data of patients who underwent MRI-compatible Medtronic InterStim placement at UPMC Williamsport, University of Minnesota, Advocate Lutheran General Hospital, and University of Wisconsin-Madison was pooled and analyzed. Patient demographics, clinical features, surgical techniques, complications, and outcomes were analyzed. Strengthening the Reporting of Observational studies in Epidemiology(STROBE) cross-sectional reporting guidelines were used.
Seventy-three patients had the InterStim implanted. The mean age was 63.29 ± 12.2 years. Fifty-seven (78.1%) patients were females and forty-two (57.5%) patients had diabetes. In addition to incontinence, overlapping symptoms included diarrhea (23.3%), fecal urgency (58.9%), and urinary incontinence (28.8%). Fifteen (20.5%) patients underwent Peripheral Nerve Evaluation before proceeding to definite implant placement. Thirty-two (43.8%) patients underwent rechargeable InterStim placement. Three (4.1%) patients needed removal of the implant. Migration of the external lead connection was observed in 7 (9.6%) patients after the stage I procedure. The explanation for one patient was due to infection. Seven (9.6%) patients had other complications like nerve pain, hematoma, infection, lead fracture, and bleeding. The mean follow-up was 6.62 ± 3.5 mo. Sixty-eight (93.2%) patients reported significant improvement of symptoms on follow-up evaluation.
This study shows promising results with significant symptom improvement, good efficacy and good patient outcomes with low complication rates while using MRI compatible InterStim for FI. Further long-term follow-up and future studies with a larger patient population is recommended.
World journal of radiology. 2024 Feb 28 [Epub]
Binit Katuwal, Amy Thorsen, Kunal Kochar, Ryba Bhullar, Ray King, Ernesto Raul Drelichman, Vijay K Mittal, Jasneet Singh Bhullar
Department of Surgery, Ascension Providence Hospital, Michigan State University College of Human Medicine, Southfield, MI 48075, United States., Department of Colon and Rectal surgery, Alina Health Abbott Northwestern Hospital, Minneapolis, MN 55407, United States., Colon and Rectal Surgery, Advocate Illinois Masonic, Park Ridge, IL 60068, United States., Volunteer Student, Department of Research, Ascension Providence Hospital, Southfield, MI 48075, United States., Colon and Rectal Surgery, University of Wisconsin, Madison, WI 53715, United States., General and Colorectal Surgery, Ascension Providence Hospital, Michigan State University College of Human Medicine, Southfield, MI 48075, United States., Department of Surgery, Department of Medical Education, Ascension Providence Hospital, Michigan State University College of Human Medicine, Southfield, MI 48075, United States., General and Colorectal Surgery, Ascension Providence Hospital, Michigan State University College of Human Medicine, Southfield, MI 48075, United States. .
PubMed http://www.ncbi.nlm.nih.gov/pubmed/38455883