A review of sacral nerve stimulation for faecal incontinence following rectal surgery and radiotherapy

Abstract

Larger studies with better patient selection are needed to investigate the effect of SNS on incontinence following radiotherapy or rectal surgery.

International Continence Society best practice statement for use of sacral neuromodulation

“…[67][68][69] Success was noted in 47-100% of patients subjected to a test implantation and QOL was generally improved. 67 The difficulty in interpreting this data is that the patient groups are heterogeneous. Some, but not all, of the patients had radiation for rectal cancer, and the rectal resections were done for different disease processes such as cancer or Crohn's disease.…”

“…As these patients have altered anatomy after resection of the rectum, it is unclear how much benefit SNM may play in achieving relief of symptoms. Two separate studies were conducted on the utility of SNS in LARS . Success was noted in 47‐100% of patients subjected to a test implantation and QOL was generally improved .…”

“…Two separate studies were conducted on the utility of SNS in LARS . Success was noted in 47‐100% of patients subjected to a test implantation and QOL was generally improved . The difficulty in interpreting this data is that the patient groups are heterogeneous.…”

Sacral nerve stimulation as a therapy for fecal incontinence

“…The respondents agreed (85-98.5 %) that SNS might be useful in the case of fecal incontinence following anterior rectal resection, after low anterior rectal resection and chemoradiotherapy, following anorectal surgery, and status post pelvic irradiation. The board of experts unanimously shares this view ( [7,8]; . Fig.…”

Neuromodulation for low-anterior resection syndrome

“…Another review of SNS for fecal incontinence following rectal cancer and radiotherapy highlighted the heterogeneity in operations performed, doses of radiotherapy received and the wide variation in patient symptoms as barriers to draw meaningful conclusions, however, they did note that implantation of SNS improved symptoms and quality of life in patients [17].…”