{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T12:46:20Z","timestamp":1792154780433,"version":"4.4.0"},"reference-count":38,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T00:00:00Z","timestamp":1791849600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The American Surgeon\u2122"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>We aimed to investigate the association between preoperative anorectal physiology testing (APT) and outcomes of sacral neuromodulation (SNM) for fecal incontinence (FI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This is a retrospective review of a prospective database of patients with FI who underwent SNM (2011-2020). Patients who underwent at least one preoperative APT were in the preoperative test group, those not tested served as controls. The Wexner\/Cleveland Clinic Florida-Fecal Incontinence Score (Wexner\/CCF-FIS) was calculated before implantation and at last follow-up. Preoperative workup included anal manometry (AM), electromyography (EMG), pudendal nerve terminal motor latency (PNTML), anal ultrasound (AUS), and defecography (DG). Primary outcome was treatment success, defined as at least 50% reduction from baseline on the Wexner\/CCF-FIS at last follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>102 patients (mean age: 62.7 \u00b1 13.9\u00a0years; 94 (92.2%) female) were included. Median preoperative Wexner\/CCF-FIS was 18 (IQR: 15-20), which decreased to 10 (IQR: 4-15) at last follow-up. Anal manometry was performed in 55 (53.9%), AUS in 74 (72.5%), PNTML in 71 (69.6%), EMG in 76 (74.5%), and DG in 28 (27.5%). The overall success rate was 49%; median follow-up was 56\u00a0months (IQR: 23.25-79). Overall rates of 30-day complications, device explantation, and redo SNM were 19.6, 3.9, and 5.9%, respectively. 30-day complication rates were 25% in patients without any preoperative testing and 18.3% in those who received at least one preoperative test.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Routine preoperative APT was not associated with clearly better outcomes after SNM; however, the non-randomized nature of the study, selective test ordering, and limited sample size preclude definitive conclusions of absence of clinically relevant associations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00031348261496601","type":"journal-article","created":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T16:49:25Z","timestamp":1791910165000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["What is the Role of Anorectal Physiology Testing and Imaging in the Era of Sacral Neuromodulation? A Single-Center Experience and Literature Review"],"prefix":"10.1177","author":[{"given":"Emanuela S.","family":"Alvarenga","sequence":"first","affiliation":[{"name":"Cleveland Clinic Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7854-5244","authenticated-orcid":false,"given":"Sameh Hany","family":"Emile","sequence":"additional","affiliation":[{"name":"Mansoura University Hospitals"},{"name":"Cleveland Clinic Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-7405-9864","authenticated-orcid":false,"given":"Melissa","family":"Ulbrick","sequence":"additional","affiliation":[{"name":"Cleveland Clinic Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zoe","family":"Garoufalia","sequence":"additional","affiliation":[{"name":"Cleveland Clinic Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6954-4733","authenticated-orcid":false,"given":"Victor","family":"Strassmann","sequence":"additional","affiliation":[{"name":"Cleveland Clinic Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felice","family":"De Stefano","sequence":"additional","affiliation":[{"name":"Cleveland Clinic Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric G.","family":"Weiss","sequence":"additional","affiliation":[{"name":"Cleveland Clinic Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,10,13]]},"reference":[{"key":"e_1_3_6_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ogc.2015.10.005"},{"key":"e_1_3_6_3_2","unstructured":"Alvarenga ES Zerhouni Y Wexner SD. Surgical Treatment of Anal Incontinence. In: Cardozo L Staskin D eds. Textbook of Female Urology and Urogynecology. 5th ed.CRC Press. Chapter 64. 2023."},{"key":"e_1_3_6_4_2","first-page":"9","article-title":"Surgery for fecal incontinence in adults","volume":"2010","author":"Brown SR","year":"2010","unstructured":"Brown SR, Wadhawan H, Nelson R. Surgery for fecal incontinence in adults. 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