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Successful sacral neuromodulation treatment of refractory faecal incontinence in a patient with spina bifida and partial sacral agenesis.

Publication ,  Journal Article
Luchristt, D; Kawasaki, A
Published in: BMJ Case Rep
September 5, 2023

A woman in her early 20s with a history of lumbosacral lipomyelomeningocele with associated partial sacral agenesis and tethered cord was referred for possible sacral neuromodulation treatment of her refractory faecal incontinence. Anorectal testing revealed a thinned and weakened anal sphincter complex with absent left-sided bulbocavernosus and anal wink reflexes.Through a two-stage approach, she underwent successful placement of a chronic tined quadripolar sacral nerve lead and implanted pulse generator. Despite significant distortion of normal bony anatomic landmarks, bilateral S3 and S4 foraminal entry was possible, with intraoperative motor and sensory testing providing key confirmation of appropriate lead placement. The patient had a substantial improvement in her baseline frequency and urgency with a near-complete resolution of faecal incontinence episodes during her test phase.

Duke Scholars

Published In

BMJ Case Rep

DOI

EISSN

1757-790X

Publication Date

September 5, 2023

Volume

16

Issue

9

Location

England

Related Subject Headings

  • Spinal Dysraphism
  • Sacrococcygeal Region
  • Humans
  • Female
  • Fecal Incontinence
  • Electric Stimulation Therapy
  • 42 Health sciences
  • 32 Biomedical and clinical sciences
  • 1103 Clinical Sciences
 

Citation

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Luchristt, D., & Kawasaki, A. (2023). Successful sacral neuromodulation treatment of refractory faecal incontinence in a patient with spina bifida and partial sacral agenesis. BMJ Case Rep, 16(9). https://doi.org/10.1136/bcr-2023-254835
Luchristt, Douglas, and Amie Kawasaki. “Successful sacral neuromodulation treatment of refractory faecal incontinence in a patient with spina bifida and partial sacral agenesis.BMJ Case Rep 16, no. 9 (September 5, 2023). https://doi.org/10.1136/bcr-2023-254835.
Luchristt, Douglas, and Amie Kawasaki. “Successful sacral neuromodulation treatment of refractory faecal incontinence in a patient with spina bifida and partial sacral agenesis.BMJ Case Rep, vol. 16, no. 9, Sept. 2023. Pubmed, doi:10.1136/bcr-2023-254835.

Published In

BMJ Case Rep

DOI

EISSN

1757-790X

Publication Date

September 5, 2023

Volume

16

Issue

9

Location

England

Related Subject Headings

  • Spinal Dysraphism
  • Sacrococcygeal Region
  • Humans
  • Female
  • Fecal Incontinence
  • Electric Stimulation Therapy
  • 42 Health sciences
  • 32 Biomedical and clinical sciences
  • 1103 Clinical Sciences