Reliability of Electrophysiologic Anal Tests in Predicting the Outcome of Sacral Nerve Modulation for Fecal Incontinence

Abstract

Simple anal sphincter electromyography can predict the outcome of the peripheral nerve evaluation with good positive predictive value and specificity in patients with fecal incontinence. Other, more expensive, electrophysiologic anal tests do not add further prognostic information.

Sacral Nerve Stimulation in Fecal Incontinence: Are There Factors Associated with Success?

“…Our results do not agree with a previous report, which showed that a normal anal sphincter electromyography had a good positive predictive value for the outcome of the stimulation test. 17 Results were different after permanent implantation. According to our data, patients with a prolonged sacral reflex showed a better response to permanent stimulation than those with a normal reflex latency.…”

Sacral Nerve Stimulation for Fecal Incontinence Related to External Sphincter Atrophy

“…in any case, the clinical value of grading atrophy has not yet been established. 32,33 Our study had several limitations. This result is consistent with previous observations by Terra et al 2 and Voyvodic et al 26 The value of measuring PNTML in defining pudendal neuropathy remains controversial, [27][28][29] and no correlation has been found between prolonged PNT-ML and anal squeeze pressures.…”

Predictive factors for successful sacral nerve stimulation in the treatment of faecal incontinence: a 10‐year cohort analysis

“…Direct motor contraction of the external sphincter may also occur at higher amplitudes. Normal EAS electromyography has previously been shown to be a significant predictive factor for successful outcome in the treatment of FI by SNS [20]. It has also been suggested that the amplitude required to elicit a reflex response is dependent on the proximity of the electrode to the nerve [6].…”