AB025. SOH21AS256. Clinical and functional outcomes of sacral nerve neuromodulation for the management of functional bowel disorders

Background: Sacral nerve neuromodulation using a sacral nerve stimulator (SNS) is a well-established treatment option for the management of bowel and bladder dysfunction. The aim of treatment is to improve quality of life. We aimed to report clinical and quality of life outcomes in patients treated with SNS for bowl dysfunction over a ten-year period. Methods: Patients who underwent temporary wire insertion and subsequent permanent wire insertion under fluoroscopic guidance were identified from theatre records. Permanent wires were attached to the SNS battery (Medtronic) placed in the subcutaneous tissue of the buttock. Demographic and clinical data was identified including indication for SNS insertion and 30-day morbidity. Faecal Incontinence Quality of Life (FIQOL) questionnaire was used to assess improvement in QoL following SNS insertion for treatment of faecal incontinence. Results: Over a ten-year study period 239 temporary wires were placed of which 46% (n=110) of patients proceeded to permanent wire and SNS device placement. The majority of patients had an SNS inserted for faecal incontinence, 73% (n=80) and other indications included: constipation, Parkinson’s disease, colonic dysfunction, and patients who had spinal cord injuries and cauda equina syndrome. Thirty-day morbidity for permanent wire placement was 1.8% (n=2), one patient developed seroma and one a haematoma at the battery site. At follow-up, two patients required re-positioning of wire and two patients removal of the SNS. Favourable QoL outcomes were reported in both patients treated for incontinence and those treated for other indications. Conclusions: Sacral nerve modulation has a broad role in the management of functional bowel disorders. A good response to temporary wire placement accurately selects patients who will benefit from SNS placement.