Efficacy of Sacral Nerve Stimulation for the Treatment of Fecal Incontinence

Boyle, Derek J.; Murphy, Jamie; Gooneratne, Mayoni L.; Grimmer, Karyn; Allison, Marion; Chan, Christopher L.; Williams, Norman S.

doi:10.1097/dcr.0b013e3182270af1

Cited by 58 publications

(31 citation statements)

References 40 publications

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“…Of those that received permanent stimulation, 20 % failed to regain the benefit experienced during the evaluation phase. Of 37 patients who underwent placement of a permanent SNS, 14 had a 50 % reduction in incontinent episodes and 13 became continent [22]. These outcomes are not as favourable as those previously reported, in which PNE was successful in up to 90 and 80 % experienced a reduction in incontinent episodes [23].…”

Section: Sacral Nerve Stimulationmentioning

confidence: 52%

Advances in the Surgical Treatment of Faecal Incontinence

Thomas

Vaizey

2013

Curr Surg Rep

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Faecal incontinence is a common condition. Once conservative therapy has failed, surgical management of this problem is required. Over the last decade, neuromodulation has emerged as an effective and safe treatment. The most widely used form of neuromodulation is sacral nerve stimulation. The other less commonly used techniques are posterior tibial nerve stimulation and pudendal nerve stimulation. Anterior sphincteroplasty still has an important role to play in selected cases. If these treatments fail, then other therapies need to be considered. Recent advances in anal sphincter bulking agents and artificial sphincter devices offer some hope for these patients.

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Section: Sacral Nerve Stimulationmentioning

confidence: 52%

Advances in the Surgical Treatment of Faecal Incontinence

Thomas

Vaizey

2013

Curr Surg Rep

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“…A low-amplitude electrical current is applied to a sacral nerve, usually S3, via an electrode in the sacral foramen. An advantage of SNS over alternative surgical techniques is the ability to evaluate patient response to SNS, via a temporary external neurostimulator, before permanent neurostimulator implantation 57. SNS must be performed in the operating room and requires general or local anesthesia.…”

Section: Resultsmentioning

confidence: 99%

Current and Emerging Treatment Options for Fecal Incontinence

Rao

2014

Journal of Clinical Gastroenterology

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Fecal incontinence (FI) is a multifactorial disorder that imposes considerable social and economic burdens. The aim of this article is to provide an overview of current and emerging treatment options for FI. A MEDLINE search was conducted for English-language articles related to FI prevalence, etiology, diagnosis, and treatment published from January 1, 1990 through June 1, 2013. The search was extended to unpublished trials on ClinicalTrials.gov and relevant publications cited in included articles. Conservative approaches, including dietary modifications, medications, muscle-strengthening exercises, and biofeedback, have been shown to provide short-term benefits. Transcutaneous electrical stimulation was considered ineffective in a randomized clinical trial. Unlike initial studies, sacral nerve stimulation has shown reasonable short-term effectiveness and some complications. Dynamic graciloplasty and artificial sphincter and bowel devices lack randomized controlled trials and have shown inconsistent results and high rates of explantation. Of injectable bulking agents, dextranomer microspheres in non-animal stabilized hyaluronic acid (NASHA Dx) has shown significant improvement in incontinence scores and frequency of incontinence episodes, with generally mild adverse effects. For the treatment of FI, conservative measures and biofeedback therapy are modestly effective. When conservative therapies are ineffective, invasive procedures, including sacral nerve stimulation, may be considered, but they are associated with complications and lack randomized, controlled trials. Bulking agents may be an appropriate alternative therapy to consider before more aggressive therapies in patients who fail conservative therapies.

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“…Success rates, defined by the majority of studies as >50% reduction in symptoms, have ranged from 67 to 100% [85]. However, in a prospective 5-year study with strict definitions of success, Boyle et al reported that~74% of patients continued to have FI [85].…”

Section: Sacral Nerve Stimulationmentioning

confidence: 92%

“…However, in a prospective 5-year study with strict definitions of success, Boyle et al reported that~74% of patients continued to have FI [85]. A randomized controlled study by Tjandra et al randomized patients with FI into SNS or medical therapy group consisting of pelvic floor exercises, bulking agents and dietary manipulation.…”

Section: Sacral Nerve Stimulationmentioning

confidence: 94%

Review of organic causes of fecal incontinence in children: evaluation and treatment

Ambartsumyan

Nurko

2013

Expert Review of Gastroenterology & Hepatology

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Even though fecal incontinence (FI) in children is most commonly the result of functional constipation, there are organic conditions that can be associated with incontinence. FI has a major impact on the quality of life of those children who experience it. The general objectives of any bowel program are to achieve predictability and independence. This is achieved by manipulating colonic transit and stool consistency and by producing more controlled evacuations, usually with the use of rectal interventions. Dietary interventions and medications can be used to change stool consistency or to manipulate transit by accelerating or slowing it down. Biofeedback or other interventions that increase sphincter pressure can also be used to improve anorectal function. Enemas or suppositories can be used to empty the sigmoid colon in a more controlled manner. With the recent advent of the antegrade colonic enemas, the patient can have predictable bowel movements and become independent.

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Efficacy of Sacral Nerve Stimulation for the Treatment of Fecal Incontinence

Abstract: This study demonstrates that sacral nerve stimulation can be an effective treatment for patients with fecal incontinence; however, when analyzed by intention to treat, the symptoms of fecal incontinence continue in the majority (74%) of patients.

Cited by 58 publications

References 40 publications

Advances in the Surgical Treatment of Faecal Incontinence

Advances in the Surgical Treatment of Faecal Incontinence

Current and Emerging Treatment Options for Fecal Incontinence

Review of organic causes of fecal incontinence in children: evaluation and treatment

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