A5034877444- Pelvic floor disorders treatments
- Anorectal Disease Treatments and Outcomes
- Urinary Bladder and Prostate Research
- Gastrointestinal motility and disorders
- Hernia repair and management
- Congenital gastrointestinal and neural anomalies
- Colorectal Cancer Surgical Treatments
- Diverticular Disease and Complications
- Pediatric Pain Management Techniques
- Pressure Ulcer Prevention and Management
- Anesthesia and Pain Management
- Pelvic and Acetabular Injuries
- Myofascial pain diagnosis and treatment
- Pain Management and Placebo Effect
- Microbial Metabolites in Food Biotechnology
- Appendicitis Diagnosis and Management
- Nerve Injury and Rehabilitation
- Colorectal Cancer Screening and Detection
- Musculoskeletal pain and rehabilitation
- Gastroesophageal reflux and treatments
- Botulinum Toxin and Related Neurological Disorders
- Enhanced Recovery After Surgery
- Diet and metabolism studies
- COVID-19 and healthcare impacts
- Biliary and Gastrointestinal Fistulas
University Hospital Southampton NHS Foundation Trust
2020-2024
University of Southampton
2021
NIHR Southampton Biomedical Research Centre
2020
Southampton General Hospital
2015-2019
St Mark's Hospital
2007-2015
Basingstoke and North Hampshire Hospital
2011
St. Mark's Hospital
2008-2011
Medtronic (Ireland)
2009
American Society of Colon and Rectal Surgeons
2009
Sacral nerve stimulation (SNS) is an established treatment for faecal incontinence. We aimed to identify specific factors that could predict the outcome of temporary and permanent stimulation.A cohort analysis was performed potential predictive in 81 patients who underwent SNS at a single institution over 10-year period (June 1996 June 2006). Data were obtained from prospectively collected patient symptom diaries quality life questionnaires, operation reports, anorectal physiological...
Sphincter repair is the standard treatment for fecal incontinence secondary to obstetric external anal sphincter damage; however, results of this deteriorate over time. Sacral nerve stimulation has become an established therapy in patients with intact muscles. This study investigated its efficacy as a obstetric-related incontinence.Fecally incontinent defects who would normally have undergone overlapping primary or repeat procedure were included. Eight consecutive women (median age, 46...
Abstract Background Percutaneous, transcutaneous and sham posterior tibial nerve stimulation was compared in a prospective blinded randomized placebo-controlled trial. Methods Patients who had failed conservative treatment for faecal incontinence were to one of three groups: group 1, percutaneous; 2, transcutaneous; 3, transcutaneous. groups 1 2 received 30-min sessions twice weekly 6 weeks. In electrodes placed position but no delivered. Symptoms measured at baseline after weeks using bowel...
In patients with fecal incontinence who do not benefit from medical or behavioral treatments sacral nerve stimulation is now considered a first-line procedure. Although the efficacy of treatment appears to be sustained in short and medium term, long-term results therapy are relatively unknown.We report chronic have had more than 8 years therapy.All underwent for 1996 2002 were followed up prospectively. Data collected prospectively by use bowel habit diaries St Mark's continence scores....
Sacral nerve stimulation (SNS) is considered a first-line surgical treatment option for faecal incontinence. There little information on long-term results. The results of SNS incontinence performed at single centre over 10-year period are reported.A cohort analysis consecutive patients treated with was carried out. Data were collected prospectively using bowel habit diaries and St Mark's Cleveland Clinic scores. Treatment success defined as >50% reduction in episodes compared...
Abstract Background Sacral nerve stimulation (SNS) is an effective treatment for faecal incontinence, but only standard parameters have been used. This study assessed the clinical impact of altering parameters. Methods Twelve patients with partially improved incontinence following SNS underwent acute testing to select optimal parameters; rectal compliance was used as a surrogate marker. Parameters tested were: off; frequency 14 (standard), 31 or 6·9 Hz; and pulse duration 210 450 90 µs....
Abstract Background Sacral nerve stimulation is an established treatment for faecal incontinence. Nearly half of all patients experience loss efficacy at some point. Standard reprogramming restores some, but not all, patients. This study aimed to determine whether alternative stimulator settings would increase efficacy. Methods Patients with sustained were recruited from two international specialist centres. A number parameters tested using a double-blind randomized crossover design....
Posterior tibial nerve stimulation (PTNS) has been shown to improve faecal incontinence in the short term. The optimal treatment regimen is unclear with wide variations protocol reported literature. study aimed assess two different regimens of transcutaneous PTNS and establish whether increasing frequency increases effectiveness.Thirty patients were randomized receive once daily or twice weekly for a 6-week period. was carried out by patient at home after instruction. primary investigator...
Unilateral posterior tibial nerve stimulation has been shown to improve fecal incontinence in the short term. Posterior is believed work by of ascending afferent spinal pathways. Bilateral may activate more these This lead an improved therapeutic effect.The aim this study was assess efficacy bilateral transcutaneous for incontinence.This a single-group pilot prospective study.The conducted from June 2012 September at authors' institution.Twenty patients with were recruited consecutively....
Botulinum toxin injected into the internal anal sphincter is used in treatment of chronic fissure but there no standardised technique for its administration. This randomised single centre trial compares bilateral (either side fissure) to unilateral injection. Participants were receive (50 + 50 units) or (100 Dysport® injections an outpatient setting. Injection-related pain assessed by visual analogue scale was primary outcome measure. Secondary outcomes healing rate, pain, incontinence, and...
In Brief Objective: Pudendal nerve stimulation (PNS) aims to maximize afferent or efferent from the sacral plexus. Background: We hypothesized this may be a promising new treatment for patients with bowel dysfunction in complete cauda equina syndrome (CES). Methods: Thirteen CES [8 constipation predominant (group 1) and 5 incontinence 2)] had 3-week trial of PNS. Patients who showed 50% more improvement symptoms during phase proceeded permanent neurostimulator implantation. Results: Five...
Sacral nerve stimulation (SNS) may be offered to patients with constipation who have failed improve conservative treatment. The response SNS is variable, a significant loss of efficacy in some patients. An increased frequency the for faecal incontinence. This study aimed see if alteration pulse width or improved outcome those constipation.Eleven currently being treated by were recruited from three centres. They randomized five different protocols each applied 5 weeks. Group 1 used standard...
Purpose: Patients with functional anorectal pain in the absence of an organic cause often have symptoms that are resistant to conventional medical and behavioral therapy. This study assessed use sacral nerve stimulation treatment this condition. Methods: A 56-year-old, female subject 18-month history intermittent severe pain, any evacuatory disorder or gross pathology, underwent temporary then subsequent permanent stimulation. Treatment efficacy was measured by verbal scores obtained at...
Abstract Objective In patients undergoing sacral nerve stimulation (SNS), a temporary percutaneous wire is often used to assess the clinical response therapy prior chronic stimulation. The aim of this study was evaluate incidence bacterial colonization screening wires and risk infection in prolonged SNS screening. Method Data were collected prospectively on consecutive series for bowel dysfunction. Procedures performed using standardized technique with single shot either co‐amoxyclav 1.2 g...
Pudendal nerve stimulation (PNS), which is an alternative to sacral stimulation, requires neurophysiological confirmation of correct siting the electrode. We describe a modification existing technique where placement assisted by guidance ischial spine finger introduced per anum.Cadaveric dissection was carried out confirm accuracy this new approach. The surface marking marked. A stimulating needle electrode inserted through skin incision at point, advanced towards using anum as guide. Once...