Rockledge, Florida

Marja Sprock, M.D., FACOG, FPMRS Board Certified
Fellowship Trained Urogynecologist

Now Accepting New Patients

info@CFUroGyn.com      Phone:  321-806-3929

Recently Published

new  New Treatments for Vaginal Atrophy

new  The Healthy Weight Lifestyle Formula

new  Small Battery Can Fix Bowel Control Issues

new  Laser and the Vagina

new  Fecal Incontinence  - More Common Than You Think!

new  Overactive Bladder

new  Painful Bladder Syndrome / Interstitial Cystitis

new  Stress Urinary Incontinence

new  The Thrill is Gone

new  Chronic Constipation

Laser Treatment for Vaginal Atrophy

Have You Had Your Pap Smear?

Resources for Pelvic Floor Disorders

The Uterine Fibroid Dilemma

Are You Leaking ?

New Non-Surgical Laser Solution for Stress Urinary Incontinence

New Treatment Option for Stress Urinary Incontinence

Non-hormonal Vaginal Atrophy Treatment -- Non-painful Sex Without Estrogen

In-Office Painless Laser Vaginal Tightening

Central Florida UroGynecology Announces LASER 4D Aesthetics

Accidental Bowel Loss - A Socially Hidden Problem

Nerve Stimulation to Treat Urinary and Fecal Problems

Is UTI a Major Health Problem?

It Appeared to be an Overactive Bladder

Pessary Treatment of Prolapse

Overactive Bladder Evaluation Chart

Accidental Bowel Loss or Fecal Incontinence

Overactive Bladder Guidelines

Vaginoplasty and the “Designer Vagina”

Surgical Treatment of Stress Urinary Incontinence

Recurrent UTI - Urinary Tract Infection

Pads are "Out of Style"

Stool or Bowel Incontinence

Pain with Sex

Nightime Urination

A Tighter Vagina - the Answer to Happiness

Do not Let Urine Loss Color the Golden Years

Office Injection Procedure for Urinary Incontinence

Read a Magazine and Regain Urinary Continence

Position Statement on Mesh Midurethral Slings

Botox Covered by Insurance

Walk to Guard Against Disease!

Estrogen Treatment Possible Side-Effects Often Overstated -- Consider the Benefits!

What the doctor does not tell you…

Tips from Dr. Sprock
September 2013

Health and Feeling Good About Yourself

I have to Go All the Time

Treatments for Fecal Incontinence

Third Generation i-Lipo Xcell now available!  FIRST IN U.S.A.

Central Florida UroGynecology Opens Its New Facility on Eyster in Rockledge

Tips from Dr. Sprock
    
 March 19     March 10

But I don't have to go ...

Pelvic floor muscle training and the In Tone® device

Jessica Alba had i-Lipo, Would you?

Take Action in the New Year !!

InTone Home Device to Treat Urinary Incontinence

Regenlite Skin Tightening and Collagen Stimulation

New Options for Incontinence

Sexy Meshes ???

Control Incontinence.  Enjoy Being a Senior!

A Happy Patient Testimonial - Swimming Again After Bladder Procedure  <external>

Getting Rid of Adult Diapers

Nocturia, Nighttime Voiding

Dr. Sprock Connects with her Patients

Inches Off Where You Want Them Off - I-Lipo® Introduction

Another Incontinence Success Story

Space Coast Daily:  Dr. Sprock Does I-Lipo  <external>


Previously Published by Category

URINARY ISSUES

FECAL STOOL ISSUES

SEXUAL HELP

COSMETIC GYNECOLOGY

I-LIPO

PROLAPSE

OVERVIEW


Technical & Educational Info


All Published Articles

 

Sacral Nerve Stimulation for Fecal Incontinence
Marja Sprock, MD FACOG

Chronic involuntary loss of stool is a humiliating, debilitating and life altering condition.

Fecal incontinence occurs in about 2% of the entire population, however this increases with age. Over age 50, fecal incontinence of up to 11 % in men and 26% in women has been reported.

There are different forms of fecal incontinence:

  • Passive fecal incontinence: you are not aware of the passing of feces
  • Urge fecal incontinence: you sense an urgent need to defecate and cannot or barely make it to the toilet

The first line of treatment includes change of diet, muscle biofeedback training and anti -diarrhea/constipating measures.

Biofeedback has shown a lot of result in retraining pelvic floor muscles for better coordinated stool storage and controlled defecation.

Surgical options as post-anal repair or anterior direct or overlapping sphincter repairs have mediocre results for curing fecal incontinence, with long-term success rates of 35-50% or less.

You may have never thought about fecal incontinence, however for your friend who never wants to join you for that trip out of town or even for a lunch gathering, it may be all they think about. Can you imagine having a meeting at work with all the big bosses there and suddenly the urge for a bowel movement comes along and you know your only option is to have it go in your diaper and hope nobody will notice the smell?

Even though involuntary staining is a form of fecal incontinence, for the studies looking at the efficacy of sacral nerve stimulation, people had to have on average at least 2 fecal incontinence episodes per week for a period of 6 months.

Central Florida UroGynecology has great success stories with biofeedback pelvic floor muscle training as well as the Interstim® device.

The stool has to be formed, since it is difficult for most people to hold watery diarrhea for long. This refers back to the anti -diarrhea/constipating measures.

The presumed reason for developing fecal incontinence varies, from obstetrical/vaginal delivery trauma to occurring after previous surgery to neurogenic or spinal problems. Likely because of the influence of vaginal deliveries on the occurrence of fecal incontinence the prevalence of fecal incontinence is twice as high in women.

Several studies have been performed with implantation of an Interstim® device. The Interstim® device stimulates the sacral nerve, usually in S3, however sacral foramen 2 and 4 have also been used. Initially used for urinary incontinence it was found to have an excellent result for fecal incontinence also. In Europe it has been approved for treating both urinary and fecal incontinence since 1994, in the USA for urinary incontinence since 1997 and was not approved for fecal incontinence till 2011. In other words there are lots of people out there, having needlessly suffered for years.

Results for the implant are inspiring. One of the studies which were instrumental for FDA approval showed an achievement of 40% perfect continence, 30% achieved a 75% or greater improvement. Another very important finding is that the achieved continence continues or improves slightly over time. In other words if it works for you, it looks that it will remain to work for you.

Even if the external anal sphincter is defective, several studies have shown the Interstim® to still work

Side effects or adverse events of the implant were minimal, some people had transient implant discomfort and infection rates were described as few. Infection leading to removal of the implant was described as 4%.

Central Florida UroGynecology has an extensive experience with the Interstim® device and even though adverse events can never be minimized or neglected, the safety profile compared to other methods being offered for fecal incontinence like an artificial bowel sphincter, definitely makes the Interstim® come out positively ahead.

The Interstim® is a minimally invasive, low risk intervention. The insertion is comparable to a heart pacemaker implantation and can be entirely done under local anesthesia if needed.

The cost of the implant is substantial and usually insurance covered. The exact mechanism of how it achieves fecal continence is not exactly clear; however I highly doubt that most people would even care if it gives them their quality of life back.

Since the Interstim® works well for a lot of people, but not for everybody and is not a cheap intervention; a test phase is done beforehand. I always tell people to wait for the result of the test before making a decision to implant the bladder/bowel pacemaker or Interstim®. If you notice it will give you back control and change your life in a positive way, the decision will not be difficult. The difference with a pacemaker for the heart is that the Interstim is totally hidden; all you will see on the outside is a 2 inch (5 cm) incision/scar on the right or left upper buttock.

The test phase for Interstim for fecal incontinence will take longer than for urinary incontinence, since it will take longer to notice a positive effect. Urinating is a more frequent occurrence than defecating, so obviously to notice a difference also takes longer. For urinary incontinence the test lead is usually inserted in the office and will stay in for 4-7 days. For fecal incontinence we usually use a more permanent lead, since the testing will be more like 10-14 days.

You may have never thought about fecal incontinence, however for your friend who never wants to join you for that trip out of town or even for a lunch gathering, it may be all they think about

If the screening trial provides a good response, it is highly predictive of a good response with the full implant.

Remember, the insertion of a full implant is like the insertion of a pacemaker, only this one is for the bowel. No complicated surgery, no need for intubation. It can be done totally under local anesthesia if needed.

Success stories are numerous, but most people will not be too open about fecal incontinence. It really still is a condition that people do not talk about, it would be better if we could and would. Notice how a successful Interstim® insertion may make all the difference for you or your friend.

Come on in to Central Florida UroGynecology where we will discuss, diagnose and treat fecal incontinence.  Our experience with the Interstim® is extensive. Central Florida UroGynecology is in Rockledge Florida.  Call 321-806-3929 for an appointment or leave a note here.

   

Central Florida Urogynecology

101 Eyster Boulevard, Rockledge, FL 32955

Phone 321-806-3929

Copyright 2009-2016 Central Florida Urogynecology.  All Rights Reserved.

 

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updated:  January 11, 2016