Sacral Neuromodulation in Complex Surgical Cases May Prevent a Colostomy

Posted on: 9th Apr, 2021


Sacral neuromodulation (SNM) is a well-proven treatment that restores bladder and bowel control successfully with a minimalist outpatient procedure. Approximately 90% of patients experience success resolving bowel and bladder incontinence, even when prior treatments have failed. The technology has proven so useful that centers have begun using the SNM system to preserve and restore bowel function after complex surgery for conditions including rectal cancers in which the tissues and muscles have been damaged.

SNM to Avoid the Colostomy Bag?

No one ever wishes to have a colostomy bag, but in some cases it is necessary because the rectal surgery leaves no other good option. But what if this SNM technology allowed more people to enjoy a high quality of life and avoid the colostomy bag altogether? That is what the authors of a recent study chose to examine.

In a February 2021 publication, Enomoto and co-authors report on a series a very complex cases in which incontinence may have otherwise led to a permanent colostomy. The surgeons reasoned that SNM therapy might work because of its success in restoring the nerve and muscle function in others with fecal incontinence. SNM has been shown to help in many post-surgical situations, but a special, and likely more severe disruption, occurs in a type of surgery called intersphinteric resection (ISR) which significantly disrupts the normal muscles and tissues. As the authors write, “severe defecation disorder occurs frequently in coloanal anastomosis for low rectal cancer and may affect quality of life. Sacral neuromodulation (SNM) has been reported to be successful after rectal resection, but there are no results for patients treated with intersphincteric resection (ISR).”

In their study, SNM proved very helpful for even this most challenging group of patients, preserving bowel control despite the past surgery. The authors write, “Seven out of 10 patients did not require a permanent colostomy after SNM. SNM should be considered before performing a permanent colostomy.”

At the Continence Center here in Nevada, our team emphasizes sacral neuromodulation as the cornerstone therapy, combined with a unique pelvic floor exercise therapy regimen to restore bowel and bladder control. Studies such as this one continue to show the possible ways in which this technology may improve the quality of life of more people with bowel or bladder leakage. Contact the Sasse Surgical team today to learn more about incontinence solutions.

Enomoto, H., Nishizawa, Y., Inamori, K., Hasegawa, H., Ikeda, K., Tsukada, Y., Sasaki, T. and Ito, M., 2021. Sacral neuromodulation for the prevention of a permanent stoma in patients with severe defecation disorder following intersphincteric resection. Surgery Today, pp.1-8.

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