Sacral Nerve Stimulation
4 results
1 - 4
Pelvic Floor- A 50-year-old woman, gravida 2, para 2, comes to your office reporting chronic constipation for 30 years. Her last colonoscopy was 6 months ago; findings showed a single 6-mm tubular adenoma, which was resected. She takes a daily polyethylene glycol 3350 (PEG) powder and psyllium husk and still only has two hard bowel movements a week. She admits to frequent manual disimpaction and weekly enemas. Magnetic resonance imaging (MRI) defecography demonstrated a 1.5-cm rectocele, which emptied with evacuation, and an anorectal manometry demonstrated paradoxical squeeze and incomplete sphincter relaxation consistent with obstructive defection. What is the best initial treatment option to improve her constipation?
- A 75-year-old female patient with diabetes is in your office undergoing placement of a sacral neuromodulator lead for progressive fecal incontinence. Of the following clinical signs, which indicates that the lead is appropriately positioned?
- A 75-year-old female patient with fecal incontinence presents for stage 1 sacral neuromodulation. Upon lead stimulation, which of the following findings would be associated with optimal lead position?
- A 75-year-old man with a remote history of fistulotomy and radiation therapy for prostate cancer presents for evaluation of his worsening fecal incontinence. He has poor sphincter tone and a palpable muscular defect. Anal manometry confirms diminished resting and squeeze pressures that do not improve after pelvic floor physical therapy with biofeedback. His symptoms persist despite bowel habit optimization and sacral nerve stimulator implantation. The best next option for ths patient is