Sacral nerve stimulation for faecal incontinence

Pillinger, Stephen H.; Gardiner, Angela; Duthie, Graeme S.

Abstract

Faecal incontinence is a common problem. Conservative measures are effective in a significant proportion of patients. Failure of conservative management has until recently meant recourse to surgical intervention. Surgical treatment is often associated with disappointing results. Recently, sacral nerve stimulation (SNS) has been developed as a minimally invasive, effective technique for idiopathic and acquired faecal incontinence. The technique uses chronic low-level electrical stimulation of the sacral nerves, or neuromodulation, to produce a clinically beneficial effect on the distal colon and rectum, the pelvic floor and the anal sphincter complex. SNS is a 2-stage procedure: a diagnostic stage - temporary percutaneous nerve evaluation (PNE), and a therapeutic stage - permanent SNS. The predictive value of PNE is high, and the surgical trauma and morbidity of both procedures extremely low. The technique has been adapted from its original application in urinary dysfunction. It is almost impossible to produce level 1 evidence for this type of intervention; however, the results are superior to other interventions. Patient selection criteria are evolving, but there is a growing body of evidence that supports its use as first-line treatment for faecal incontinence in patients where conservative measures have failed.

Citation

Pillinger, S. H., Gardiner, A., & Duthie, G. S. (2005). Sacral nerve stimulation for faecal incontinence. Digestive surgery, 22(1-2), 1-5. doi:10.1159/000084344

• Journal Article Type: Review
• Acceptance Date: Dec 31, 2005
• Online Publication Date: May 11, 2005
• Publication Date: 2005
• Journal: DIGESTIVE SURGERY
• Print ISSN: 0253-4886
• Electronic ISSN: 1421-9883
• Publisher: Karger Publishers
• Peer Reviewed: Peer Reviewed
• Volume: 22
• Issue: 1-2
• Pages: 1-5
• DOI: https://doi.org/10.1159/000084344
• Keywords: SNS, sacral nerve stimulation, incontinence, faecal
• Public URL: https://hull-repository.worktribe.com/output/391153