Abstract: PD02-04
Sources of Funding: None

Introduction

An analysis of the National Health and Nutrition Evaluation Survey revealed the prevalence of fecal incontinence (FI) at 8% of non-institutionalized adults from 2005-2010. Many patients will not seek treatment due to embarrassment, and the condition is underdiagnosed. Sacral neuromodulation (SNM) has been shown to be successful for FI patients who have failed conservative management, and with our expertise in SNM and pelvic medicine, urologists and female pelvic medicine and reconstructive surgery (FPMRS) urologists can play a key role in treating FI. We examine the practice patterns and use of SNM for FI in a tertiary care institution with a urology FPMRS team.

Methods

The electronic medical record (EMR) for our institution was queried for all unique patients seen from October 1, 2015 to September 30, 2016. The number of patients seen for a diagnosis of FI (ICD-10 R15.9 and R32) was then determined for the institution as a whole, the urology department, and the FPMRS urology providers. The patients who underwent first stage SNM for FI were then analyzed to determine the number of patients who progressed to a second stage SNM procedure.

Results

The EMR query revealed a patient population of 217,664, with 10,747 seen in the urology department. 1,799 (0.8%) were seen with a diagnosis of FI in the institution as a whole. 20.7% of FI patients were seen in urology, with the majority (65.9%) seen by FPMRS providers. Fourteen patients underwent first stage SNM, and all of them progressed to a second stage procedure.

Conclusions

In our medical center, the number of patients seen for FI (0.8%), was significantly lower than the prevalence of the condition in the general population. A large number of these patients are seen by urologists, and specifically by FPMRS providers. Despite a published success rate of >80%, only a fraction of these (5.7%) underwent a SNM procedure. Because patients with urinary incontinence are more likely to have FI, urologists are in a unique position to identify these patients and offer them treatment that can potentially improve their quality of life. We acknowledge a gap in diagnosis and care of patients with FI and an opportunity for urologists to help patients with this devastating yet treatable condition.

Funding

None