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Permanent sacral nerve stimulation for fecal incontinence.
A J Malouf1, C J Vaizey, R J Nicholls
1St. Mark's Hospital, London, United Kingdom.
Annals of Surgery
|June 22, 2000
Summary
Permanent sacral nerve stimulation significantly improves fecal incontinence in women, offering long-term therapeutic benefits for various causes like sphincter weakness and disruption.
Area of Science:
- Neurology
- Gastroenterology
- Urology
Background:
- Previous studies indicated short-term benefits of sacral nerve stimulation for fecal incontinence.
- Acute evaluations suggested mechanisms involving rectal/anal muscle activity and external sphincter facilitation.
Purpose of the Study:
- To assess the long-term effectiveness of permanent sacral nerve stimulation (SNS) for fecal incontinence.
- To identify suitable patient indications and understand the mechanism of action for this therapy.
Main Methods:
- A cohort of five women with chronic fecal incontinence underwent permanent sacral nerve stimulation implantation.
- Patients were followed for a median of 16 months, with assessments of incontinence type, severity, and quality of life.
Main Results:
- All patients experienced marked improvement in fecal incontinence, with resolution of urgency and significant reduction in soiling.
- Continence scores improved substantially (median 16 to 2), and quality of life assessments were positive.
- No major complications were reported; minor issues included local pain and electrode displacement in one patient.
Conclusions:
- Permanent sacral nerve stimulation is a highly effective long-term treatment for fecal incontinence, particularly in patients with sphincter weakness or disruption.
- The therapy offers significant symptomatic relief and improved quality of life, with a favorable safety profile.
