[Sacral nerve modulation in coloproctology]

Sacral nerve modulation and stimulation (SNM/SNS) is a minimally invasive treatment for fecal incontinence, which has become widely established in recent years. Modulation of sacral nerve roots occurs through an electrode which is placed in the sacral foramina S2-4. By complex spinal and supraspinal mechanisms, rectal compliance is improved and anal incontinence episodes are reduced. The use of SNM is a suitable therapeutic option for nearly all causes of fecal incontinence refractory to conservative treatment. In the majority of patients, a significant reduction of incontinence episodes or a complete relief of symptoms is achieved. These results are also observed in long-term follow-up. Although the efficacy of SNM in constipation is less well established, it may be considered in patients who fail to respond to conservative measures. The role of further potential indications for SNM/SNS in coloproctological disorders is discussed in the present review.