Sacral nerve stimulation for faecal incontinence due to systemic sclerosis

Area of Science:

• Gastroenterology
• Neurology
• Surgical Innovation

Background:

• Faecal incontinence affects over one-third of systemic sclerosis patients.
• Conventional treatments for this condition are often unsuccessful.
• Sacral nerve stimulation presents a novel therapeutic option for refractory faecal incontinence.

Purpose of the Study:

• To assess the efficacy and safety of sacral nerve stimulation (SNS).
• To evaluate SNS in patients diagnosed with systemic sclerosis and faecal incontinence.

Main Methods:

• A cohort of five women with systemic sclerosis-associated faecal incontinence underwent evaluation.
• Patients failing maximal conventional therapy were screened with temporary SNS.
• Successful candidates received permanent sacral nerve stimulation implantation, with assessments including bowel diaries, quality of life surveys (SF-36), endoanal ultrasound, and anorectal manometry.

Main Results:

• Four out of five patients achieved continence at a median follow-up of 24 months.
• Significant improvements were observed in weekly incontinence episodes, urgency, and quality of life.
• Anorectal physiology demonstrated increased resting and squeeze pressures, alongside enhanced rectal sensitivity post-stimulation.

Conclusions:

• Sacral nerve stimulation is a safe and effective treatment for faecal incontinence secondary to systemic sclerosis.
• The therapeutic benefits of sacral nerve stimulation are sustained in the medium term.
• This intervention offers a viable solution for patients with treatment-resistant faecal incontinence due to scleroderma.