Sacral nerve stimulation for faecal incontinence and constipation in adults

Area of Science:

• Urology and Gastroenterology
• Neurosurgery
• Medical Devices

Background:

• Faecal incontinence (FI) and constipation significantly impair quality of life.
• Traditional surgical interventions carry risks and have variable outcomes.
• Sacral nerve stimulation (SNS) offers a less-invasive surgical option for these conditions.

Purpose of the Study:

• To evaluate the efficacy of sacral nerve stimulation (SNS) using implanted electrodes.
• To assess SNS effects on fecal incontinence (FI) and constipation in adults.

Main Methods:

• Systematic review of randomized and quasi-randomized controlled trials.
• Searched multiple databases including Cochrane, MEDLINE, EMBASE, and ClinicalTrials.gov.
• Independent screening, quality assessment, and data extraction by two authors.

Main Results:

• Limited trials suggest SNS improves continence in some FI patients.
• One trial showed reduced FI episodes compared to optimal medical therapy.
• Evidence for SNS effectiveness in constipation is inconclusive, with some trials showing no improvement and reporting adverse events.

Conclusions:

• Sacral nerve stimulation (SNS) may benefit a subset of patients with fecal incontinence (FI).
• Current evidence does not support SNS for treating constipation.
• Further high-quality randomized trials are required to confirm SNS efficacy and safety for both conditions.