{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T06:30:29Z","timestamp":1778049029261,"version":"3.51.4"},"reference-count":35,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2012,9,7]],"date-time":"2012-09-07T00:00:00Z","timestamp":1346976000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2012,9,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Sacral nerve stimulation is an established treatment for faecal incontinence. Nearly half of all patients experience loss of efficacy at some point. Standard reprogramming restores efficacy for some, but not all, patients. This study aimed to determine whether alternative stimulator settings would increase treatment efficacy.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Patients with sustained loss of efficacy were recruited from two international specialist centres. A number of alternative stimulation parameters were tested using a double-blind randomized crossover study design. Stimulation settings tested were pulse frequencies of 6\u00b79 and 31 Hz, and pulse widths of 90 and 330 \u00b5s, compared with one standard setting of 14 Hz\/210 \u00b5s. Treatment efficacy was evaluated using a disease-specific quality-of-life score (Fecal Incontinence Quality of Life Scale, FIQLS) and a bowel habit diary completed before randomization, during the study period and after 3 months of follow-up with one preferred setting.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Fifteen patients were analysed. With one preferred setting, three of four subdomains in the FIQLS improved significantly. The mean(s.d.) total number of incontinence episodes dropped from 11\u00b77(10\u00b78) to 4\u00b78(4\u00b75) per 3 weeks (P = 0\u00b7011) and improvements were maintained after 3 months of follow-up. Optimal pacemaker settings were individual, but a trend towards highest patient satisfaction and improved treatment outcome was evident for high-frequency stimulation (31 Hz\/210 \u00b5s), which was preferred by eight of the 15 patients.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Patients experiencing loss of efficacy can experience improvement if alternative pacemaker settings are tested. High-frequency stimulation (31 Hz\/210 \u00b5s) was preferred by more than half of the patients, and improved treatment outcome was sustained at 3 months. Registration number: NCT01254695 (http:\/\/www.clinicaltrials.gov).<\/jats:p>\n               <\/jats:sec>","DOI":"10.1002\/bjs.8867","type":"journal-article","created":{"date-parts":[[2012,9,7]],"date-time":"2012-09-07T14:19:20Z","timestamp":1347027560000},"page":"1445-1452","source":"Crossref","is-referenced-by-count":29,"title":["Randomized double-blind crossover study of alternative stimulator settings in sacral nerve stimulation for faecal incontinence"],"prefix":"10.1093","volume":"99","author":[{"given":"J","family":"Duelund-Jakobsen","sequence":"first","affiliation":[{"name":"Surgical Research Unit, Department of Surgery P, Aarhus University Hospital, Aarhus, Denmark"},{"name":"Physiology Unit, St Mark's Hospital, Harrow, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T","family":"Dudding","sequence":"additional","affiliation":[{"name":"Physiology Unit, St Mark's Hospital, Harrow, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E","family":"Bradshaw","sequence":"additional","affiliation":[{"name":"Physiology Unit, St Mark's Hospital, Harrow, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S","family":"Buntzen","sequence":"additional","affiliation":[{"name":"Surgical Research Unit, Department of Surgery P, Aarhus University Hospital, Aarhus, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L","family":"Lundby","sequence":"additional","affiliation":[{"name":"Surgical Research Unit, Department of Surgery P, Aarhus University Hospital, Aarhus, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S","family":"Laurberg","sequence":"additional","affiliation":[{"name":"Surgical Research Unit, Department of Surgery P, Aarhus University Hospital, Aarhus, 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