Fecal Incontinence Care Pathway Alex Rogers MD Sansum

Fecal Incontinence Care Pathway Alex Rogers, MD Sansum Clinic Urology 4151 Foothill Road Santa Barbara, CA 93110 Phone: 805 -681 -7564 Initial Assessment Medical History and Physical Exam, Gastroenterology Evaluation Conservative Therapies Antidiarrheals Dietary changes Fiber supplements Scheduled Stooling Adequately Managed Continue Conservative Therapies Inadequately Managed Re-Evaluation in the Office Sacral Neuromodulation Lead Placement 2 Part Outpatient Surgeries • 2 week Sacral. Therapies Stim trial @lower back Advanced *New PNE Test (April 2020) • Procedure to trial bilateral Sacral lead wires for 7 days Medtronic Device (Therapy since 1997) • ~15 cc battery placed @buttock • Battery lasts about 4 to 7 years (2006) • Outpatient Surgical battery exchange • No MRIs below the neck • Device receiver & smartphone remote management with 7 programs (2018) • *Rechargeable device pending (1. 5 T&3 T MRI Full Body) *Fail SNM Trial Surgical Sphincteroplasty Axonics Device (FDA Approval in 2019) • ~5 cc battery placed @buttock • Battery lasts about 15 years • Weekly 1 Hour recharge with belt • Outpatient Surgical battery exchange • Full body MRI conditional (1. 5 T Full Body, 3 T Head) • Keyfob remote management with 1 program • *Non recharge Primary cell device pending