Sacral Nerve Stimulation Is a Valid Approach in Fecal Incontinence Due to Sphincter Lesions When Compared to Sphincter Repair

Abstract

These data appear to confirm that sacral nerve stimulation could represent a valid alternative in the treatment of fecal incontinence patients presenting with sphincter lesion that was not preceded by sphincteroplasty.

Long-Term Outcomes of Anal Sphincter Repair for Fecal Incontinence

“…Specifically, SNS has been proposed as a viable alternative to surgical repair in the algorithm for treating patients with incontinence and anal sphincter defects. 7,8 However, some important questions remain about the optimal treatment for surgically correctable fecal incontinence. 9 Can the additional expense of newer modalities be justified?…”

Systematic Review of Surgical Treatments for Fecal Incontinence

“…two high risk-of-bias observational studies (table 2 and appendix table 4) provided insufficient evidence for sns versus sphincteroplasty 40 and for open versus percutaneous sns lead placement. 41 follow-up between groups differed by >2 years in both studies (table 2).…”

“…40,[42][43][44][45] there was insufficient RCt evidence (table 1) to compare the effectiveness of sphincter repair with stoma/fecal diversion versus sphincter repair alone 37 from 1 high risk-of-bias RCt that assessed CCfis changes from baseline anywhere from 16 to 47 months postoperatively and did not report mean follow-up by group (table 1). there was also insufficient RCt evidence to compare the effectiveness of adjuvant biofeedback after anal sphincter repair versus sphincter repair alone 31 in 1 high risk-of-bias RCt.…”

“…sphincteroplasty versus sns,40 Comparative effectiveness of surgical treatments for fecal incontinence: randomized controlled trials with study quality ratings…”

Nitric Oxide Synthase Expression in Rat Anorectal Tissue after Sacral Neuromodulation

“…Sacral nerve stimulation (SNM) has evolved as a valid treatment option for patients with faecal incontinence, constipation, and pelvic pain who are refractory to conservative management [1][2][3][4]. Despite its efficacy, very little is known regarding the underlying mechanism of action.…”