Sacral Neuromodulation and Faecal Incontinence and Its Unknown Effect on the External Anal Sphincter

NCT ID: NCT06763861

Last Updated: 2025-01-08

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Total Enrollment

15 participants

Study Classification

OBSERVATIONAL

Study Start Date

2024-12-09

Study Completion Date

2028-12-31

Brief Summary

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This innovative project aims to investigate structures and morphology of the external anal sphincter (EAS) as well as the impact of sacral neuromodulation (SNM) on the EAS morphology and biochemistry among patients with faecal incontinence (FI).

SNM is a well implemented treatment for FI and consist of electrical stimulation of sacral nerve roots to promote continence and may even contribute to total continence. It has shown a positive effects on both short- and long-term. The biologic effect of SNM on EAS is unknown.

The aim is to investigate the effect of SNM on EAS morphology, function, and biochemistry to help physicians and researchers to understand the underlying mechanisms of SNM and the anal sphincter complex to further improve and optimize treatment methods for patients with FI.

The research project consists of three phases. The first phase includes biopsies from the EAS among patients with no previous history of FI. These patients have been diagnosed with rectal cancer and will undergo surgery with abdominoperineal excision.

The second phase includes patients diagnosed with FI and subject for implantation of SNM for treatment of FI. Prior to implantation of SNM all patients will have been examined with 3D endo-anal ultrasound and anorectal manometry as well as answered questionnaires targeting general health, bowel dysfunction and FI. A biopsy of the superficial portion of the EAS is retrieved under local anaesthesia in connection to the test period for implantation of the SNM device.

The last phase, phase three, includes 3D endo-anal ultrasound, anorectal manometry, and a second biopsy of the EAS twelve months after implantation with SNM.

The histopathological analysis in all the three phases will include general morphology, distribution of cell nuclei, satellite cells, muscle fiber type, neural structures and connective tissue.

Detailed Description

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Conditions

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Fecal Incontinence

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Patients without diagnosis of FI

Biopsies from EAS among patients diagnosed with rectal cancer and no records of previous diagnosis of FI and now receiving treatment with abdominoperineal resection.

Biopsy

Intervention Type OTHER

Biopsies from EAS

Patients diagnosed with FI

Biopsies from EAS among patients diagnosed with FI and recieving treatment with sacral neuromodulation before implantation of the device and 12 months postoperatively.

Biopsy

Intervention Type OTHER

Biopsies from EAS

Interventions

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Biopsy

Biopsies from EAS

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* ≥ 18 years of age
* Male or female
* Diagnosed with rectal cancer and receive treatment with abdominoperineal resection
* Signed an informed consent


* Diagnosed with FI and will receive treatment with sacral neuromodulation
* Male or female
* Signed an informed consent

Exclusion Criteria

* Previous diagnosis of FI
* Unable to speak and/or read Swedish to ensure informed consent
* Tumour involving the sphincter complex or is in close connection

Phase 2 and 3


* Unable to speak and/or read Swedish to ensure informed consent
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Umeå University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Karin Strigård, Prof., Senior consultant

Role: STUDY_CHAIR

Department of Diagnostics and Interventions, Umeå University

Locations

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Umeå University Hospital

Umeå, Västerbotten County, Sweden

Site Status RECRUITING

Countries

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Sweden

Central Contacts

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Strigård, Prof., Senior consultant

Role: CONTACT

+46(0)90 785 00 00

Louise Almkvist, MD

Role: CONTACT

+46(0)90 785 00 00

Facility Contacts

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Karin Strigård, Prof., Senior consultant

Role: primary

Other Identifiers

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Dnr 2024-04527-01

Identifier Type: -

Identifier Source: org_study_id

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