Is Sacral Nerve Stimulation an Effective Treatment for Chronic Idiopathic Anal Pain?

Abstract

Long-term follow-up data showing improvements in scores on the visual analog pain scale and quality of life questionnaire indicate that, before adopting more aggressive surgical procedures, SNS should be considered for patients with chronic idiopathic anal pain in whom pharmacologic and biofeedback treatments have failed to produce effective results.

Randomized clinical trial of transcutaneous electrical posterior tibial nerve stimulation versus lateral internal sphincterotomy for treatment of chronic anal fissure

“…Sacral nerve stimulation has been recently shown to be an effective treatment modality for CAF as reported in a study which included five patients suffering CAF [10]. Complications related to SNS therapy include patients discomfort at the subcutaneous tunnel in which the electrodes run [19] and superficial wound infection which occurs in 3%e17% of patients [19,20]. Invasiveness of this technique together with the high cost of the implanted stimulator electrodes limited its use in treatment of CAF.…”

Secondary changes in bowel function after successful treatment of voiding symptoms with neuromodulation

“…Improvements in comorbid pelvic pain and bowel symptoms 1,2 after sacral and more recently, chronic pudendal neuromodulation for voiding complaints 3,4 have already been observed. Studies have also reported encouraging results after treating fecal incontinence (FI), 5 constipation, 6,7 irritable bowel syndrome (IBS), 8 and anorectal pain 9 with neuromodulation.…”

Patient Experience and Satisfaction With Sacral Neuromodulation: Results of a Single-Center Sample Survey

“…7-10 SNM has also recently been used to treat functional anorectal and pelvic pain. [11][12][13][14] To this date most studies on SNM have focused on clinical efficacy or technique improvement. The outcome parameters used were mainly clinically oriented; for example, a Ͼ50% improvement in total episodes of incontinence, increased bowel frequency, reduction in pain scores, and the occurrence of adverse events.…”