Sacral nerve stimulation for faecal incontinence and constipation in adults

Area of Science:

• Urology
• Gastroenterology
• Neurology

Background:

• Faecal incontinence and constipation significantly impact quality of life.
• Sacral nerve stimulation (SNS) is a minimally invasive option for refractory cases.
• SNS modulates pelvic floor and hindgut nerves and muscles.

Purpose of the Study:

• To evaluate the efficacy of sacral nerve stimulation (SNS) for adult faecal incontinence and constipation.
• To synthesize evidence from randomized and quasi-randomized trials.

Main Methods:

• Searched Cochrane Incontinence Group Specialised Trials Register and reference lists.
• Included randomized or quasi-randomized trials on SNS for faecal incontinence or constipation in adults.
• Independent screening, quality assessment, and data extraction by two reviewers.

Main Results:

• Three crossover studies were included (totaling 38 participants).
• SNS showed potential to reduce faecal incontinence episodes in some participants.
• For constipation, SNS increased bowel movement frequency and reduced bloating and pain.

Conclusions:

• Limited evidence suggests SNS may improve continence and constipation symptoms in selected individuals.
• Short-term (2-3 week) stimulation may not reliably identify suitable candidates for permanent implants.
• Larger, high-quality randomized crossover trials are required to confirm SNS efficacy and identify optimal patient selection criteria.