PTH-258 Effect of opioid medication use on outcome of sacral neuromodulation in patients with slow transit constipation

Abstract

Introduction Sacral Nerve Stimulation (SNM) is an accepted treatment in patients with slow transit constipation (STC). Opioid medication use (which is recognised to prolong colonic transit) is often seen in patients with STC. Whether concurrent use of opioids affects the success, or otherwise, of patients undergoing SNM has not been previously investigated. Method All patients with STC undergoing SNM in a 9 year period within a single centre were identified. Patients prescribed two or more opioid drugs at the time of temporary SNM trial were defined as opioid-users. Outcome of the temporary SNM trial and subsequent permanent SNM implantation was determined. Results 32 patients (30 female, 2 male; median age [range] 50 [21–70] years) with STC underwent temporary SNM trial. 12/32 [38%] patients were opioid users and 20/32 (62%) patients non-opioid users. Overall, 20/32 (63%) patients had a successful temporary SNM trial. There was no difference in outcome of temporary SNM trial between opioid- or non-opioid users (successful outcome in 6/12 [50%] opioid-users, 14/20 (70%) non-opioid users; P = 0 .29, Fishers exact test). 15/20 patients who underwent successful temporary SNM trial progressed to permanent SNM implantation, of which 8/15 (53%) had a successful outcome. There was no difference in outcome of permanent SNM between opioid- or non-opioid users (successful outcome in 3/5 [60%] opioid-users, 8/10 (80%) non-opioid users; P = 0.56, Fishers exact test). Conclusion Concurrent use of opioid medication in patients with STC does not affect the success rate of either temporary or permanent SNM. Disclosure of interest None Declared.