Practice patterns in the diagnosis and treatment of fecal incontinence with sacral neuromodulation: Can urologists impact this gap in care?

Özet

Objective: The prevalence of fecal incontinence (FI) is 8% in the United States. Many patients will not seektreatment and the condition is underdiagnosed. Sacral neuromodulation (SNM) is effective in treating FI,and so urologists can play a key role in its treatment. We examine the practice patterns and treatment of FIwith SNM in our institution.Material and methods: The electronic medical record was queried for the proportion of patients seen forFI in the institution, the urology department, and among the female pelvic medicine and reconstructivesurgery (FPMRS) urologists. The patients who underwent SNM for FI were evaluated for progression tosecond stage procedure.Results: The proportion of patients seen for FI is 0.96% in the institution as a whole, 7.9% in the urologydepartment, and 17.9% among FPMRS urologists. Fourteen patients underwent first stage SNM for FI ordual urinary/fecal incontinence, and they all progressed to a second stage procedure. Thirteen of these wereperformed by FPMRS urologists.Conclusion: In our institution, the proportion of patients seen for FI was lower than the prevalence of thiscondition. Because patients with urinary incontinence are more likely to have FI, urologists are in a uniqueposition to identify these patients and offer treatment that can improve their quality of life. We acknowledgea gap in care of the patients with FI and an opportunity for urologists to help patients with this devastatingyet treatable condition.