[Sacral neuromodulation in fecal continence disorders].

Area of Science:

• Neuroscience
• Gastroenterology
• Urology

Background:

• Conventional therapies for fecal incontinence often yield limited long-term success, especially when not caused by structural damage.
• Fecal incontinence significantly impacts patients' quality of life and incurs social costs.
• Sacral neuromodulation, successful in treating bladder incontinence, presents a potential alternative for fecal incontinence.

Purpose of the Study:

• To detail the application of sacral neuromodulation using Interstim (Medtronic) devices for fecal incontinence.
• To discuss the indications, protocol, and early outcomes of this therapeutic approach.
• To review current literature and present initial findings from our experience.

Main Methods:

• Application of magnetic stimulation to sacral roots to modulate autonomic nervous system reflex activity.
• Utilized Interstim (Medtronic) devices following a protocol established with the Italian Group of Sacral Neuromodulation (GINS).
• Evaluation included instrumental and clinical assessments, alongside subjective quality of life assessments.

Main Results:

• Early and intermediate results indicate success in achieving complete recovery or significant improvement in fecal continence.
• Both clinical evidence and subjective patient evaluations of quality of life demonstrate positive outcomes.
• The technique is considered 'work in progress' with ongoing research into its precise mechanisms of action on pelvic floor and colorectal motility.

Conclusions:

• Sacral neuromodulation is a viable and promising therapeutic option for fecal incontinence.
• The technique shows potential for long-term correction of fecal incontinence, improving patient quality of life.
• Further research is needed to fully elucidate the mechanisms and long-term efficacy, with ongoing studies exploring its use in refractory constipation.