Sacral nerve stimulation for faecal incontinence: its role in the treatment algorithm
Article first published online: 1 FEB 2011
© 2011 The Author. Colorectal Disease © 2011 The Association of Coloproctology of Great Britain and Ireland
Special Issue: The Role of Sacral Nerve Stimulation in Treating Faecal Incontinence and Refractory Constipation
Volume 13, Issue Supplement s2, pages 10–14, March 2011
How to Cite
Matzel, K. E. (2011), Sacral nerve stimulation for faecal incontinence: its role in the treatment algorithm. Colorectal Disease, 13: 10–14. doi: 10.1111/j.1463-1318.2010.02519.x
- Issue published online: 1 FEB 2011
- Article first published online: 1 FEB 2011
- Received 13 September 2010; accepted 19 November 2010
- Anal incontinence;
- faecal incontinence;
- sacral nerve stimulation;
- sacral neuromodulation;
- sphincter lesion;
- sphincter repair
Aim Indications for sacral nerve stimulation (SNS) for faecal incontinence have expanded over the last decade. This report aims to determine the clinical outcome of the current use of SNS in the treatment of faecal incontinence. Its objective is also to review the most recent role of SNS in patients with anal sphincter lesions.
Method The literature was searched using Medline and Cochrane databases. The search was restricted to publications in English. For the analysis, studies with < 25 patients were excluded. For SNS in patients with sphincter defects, all papers were included.
Results Thirteen publications on the clinical outcome of SNS were included. Nine papers were identified reporting the application of SNS in patients with a morphological sphincter lesion. The most common outcome measures of clinical efficacy were frequency of incontinence using the Cleveland Clinic Incontinence Score. All studies demonstrated highly improved function across all outcome measures and improvement was statistically significant in all. Outcomes remain stable at long-term follow up. In patients with sphincteric gaps ranging from 17 to 180°, SNS was clinically effective at short-term follow up. The size of the gap appears to have no impact on outcome.
Conclusion SNS has evolved to become a clinical efficient therapy applicable across a wide spectrum of causes of faecal incontinence with reproducible results. SNS can be considered to be an essential part of the current surgical treatment algorithm for faecal incontinence.